Early introduction of hemodialysis for metformin-induced lactic acidosis : A case report

Ogawa Naoko, Tsurukiri Junya, Sano Hidefumi, Numata Jushi, Nagura Takeo, Moriya Mariko, Oda Jun

doi:10.57388/jjct.36.1_27

Bibliographic Information

Other Title

メトホルミン過量服薬による乳酸アシドーシスに対して早期の血液透析導入が有用であった1例
メトホルミンカリョウフクヤクニヨルニュウサンアシドーシスニタイシテソウキノケツエキトウセキドウニュウガユウヨウデアッタ 1レイ

Search this article

Abstract

<p>Metformin-associated lactic acidosis is a life-threatening condition characterized by an elevation in serum lactate level in patients with metformin exposure. Here we report a case of lactic acidosis due to metformin overdose, who underwent early introduction of intermittent hemodialysis and successful clinical improvement. An adult patient who had treated diabetes was transferred to our emergency center because of metformin overdose 8 hours before. The patient took a total 54.5 g of metformin and 7.5 mg of repaglinide, and lactic acidosis (pH of 7.299 and lactate levels of 10.4 mmol/L) was determined on hospital arrival. Renal dysfunction and hyperkalemia were also determined and we diagnosed the patient as lactic acidosis caused by metformin overuse. After hospital admission, lactate was continuously increased and we decided to introduce intermittent dialysis 6 hours later on admission because we concerned the exacerbation of lactic acidosis caused by metformin overuse. Successful clinical improvement of the patient was observed because of two times of intermittent dialysis. We concluded that early introduction of intermittent dialysis should be considered as one of the treatment options of lactic acidosis caused by metformin overuse.</p>

Journal

Japanese Journal of Clinical Toxicology

Japanese Journal of Clinical Toxicology 36 (1), 27-31, 2023-03-10

Japanese Society for Clinical Toxicology

Keywords

Details 詳細情報について

Export