The use of metformin in patients with type 2 diabetes mellitus has been associated with lactic acidosis. However, the information available in patients with moderate-severe chronic kidney disease is scarce. The ALIMAR-C2 study is a case-control study to assess the association between metformin and lactic acidosis in patients with type 2 diabetes mellitus and moderate-severe chronic kidney disease. The study will be performed with computerized registered electronic health records from eight Spanish hospitals linked to their corresponding primary care health areas from to , comprising approximately
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2010, Número 3
As it is renally cleared it should be used with caution in patients with renal impairment. Elevated plasma metformin concentrations, may lead to severe lactic acidosis. Metformin- associated lactic acidosis MALA is a rare but potentially life-threatening condition. As metformin is highly water soluble, it can be removed by hemodialysis if dialysis is conducted for long enough to mobilize the intracellular form. A literature review, found that dialysis techniques proved to be better than supportive care, in MALA patients. Larger studies are needed to draw firmer recommendations on the treatment of MALA, especially concerning the possible beneficial effects of dialysis in this context. We report on a year-old male type 2 diabetic patient, who presented with septic shock and severe lactic acidemia, in which metabolic acidosis was only corrected after performing continuous renal replacement therapy.
Acidosis láctica asociada a metformina
American Diabetes Association. Total prevalence of diabetes and pre-diabetes. Accessed October 5, Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. Diabetes Care ; Lancet ;
U.S. Food and Drug Administration
United Kingdom Prospective Diabetes Study.. ISSN: Metformin and lactic acidosis: infrequent association or causality?. Descargar PDF. Carral San Laureano. Hospital Universitario Puerto Real.