Indian Journal of Critical Care Case Report

Register      Login

VOLUME 1 , ISSUE 1 ( July-August, 2022 ) > List of Articles

CASE REPORT

Metformin and Acute Kidney Injury: Recipe for Disaster

Dhanushree Jayaramaiah, Padmakumar V Arayamparambil, Ganesh K Manjunatha

Keywords : Acute kidney injury, Hemodialysis, Metformin, Metformin-associated lactic acidosis, Type II diabetes mellitus

Citation Information : Jayaramaiah D, Arayamparambil PV, Manjunatha GK. Metformin and Acute Kidney Injury: Recipe for Disaster. 2022; 1 (1):13-15.

DOI: 10.5005/jp-journals-11006-0005

License: CC BY-NC 4.0

Published Online: 31-08-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Type II diabetes is a common disease worldwide and, metformin is one of the first line of drugs used in its treatment. Metformin elimination is mainly through the kidney; hence when the patient develops dehydration and acute kidney injury, it will lead to life-threatening lactic acidosis. Hemodialysis improves the patient's condition rapidly. We would like to present two patients who were on metformin and developed life-threatening lactic acidosis with hemodynamic instability following an episode of acute gastroenteritis and acute kidney injury. Hemodialysis hastened the recovery emphasizing the need for early identification and treatment.


PDF Share
  1. Pernicova I, Korbonits M. Metformin–mode of action and clinical implications for diabetes and cancer. Nat Rev Endocrinol 2014;10(3):143–156. DOI: 10.1038/nrendo.2013.256
  2. Rafieian-Kopaei M, Nasri H. Ginger and diabetic nephropathy. J Ren Inj Prev 2013;2(1):9–10. DOI: 10.12861/jrip.2013.05
  3. Salpeter SR, Greyber E, Pasternak GA, et al. Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus. Cochrane Database of Systematic Reviews 2010;(4):CD00296. DOI: 10.1002/14651858.CD002967.pub4
  4. DeFronzo R, Fleming GA, Chen K, et al. Metformin-associated lactic acidosis: current perspectives on causes and risk. Metab - Clin Exp 2016;65(2):20–29. DOI: 10.1016/j.metabol.2015.10.014
  5. Scheen A. Metformin and lactic acidosis. Acta Clin Belg 2011;66(5):329–331. DOI: 10.2143/ACB.66.5.2062583
  6. Connelly PJ, Lonergan M, Soto-Pedre E, et al. Acute kidney injury, plasma lactate concentrations and lactic acidosis in metformin users: a GoDarts study. Diabetes Obes Metab 2017;19(11):1579–1586. DOI: 10.1111/dom.12978
  7. Lazarus B, Wu A, Shin JI, et al. Association of metformin use with risk of lactic acidosis across the range of kidney function: a community-based cohort study. JAMA Intern Med 2018;178(7):903–910. DOI: 10.1001/jamainternmed.2018.0292
  8. Angioi A, Cabiddu G, Conti M, et al. Metformin associated lactic acidosis: a case series of 28 patients treated with sustained low-efficiency dialysis (SLED) and long-term follow-up. BMC Nephrol 2018;19(1):77. DOI: 10.1186/s12882-018-0875-8
  9. Arroyo D, Melero R, Panizo N, et al. Metformin-associated acute kidney injury and lactic acidosis. Int J Nephrol 2011:749653. DOI: 10.4061/2011/749653
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.