Iodine-based radiographic contrast medium may precipitate metformin-associated lactic acidosis in diabetic patients. A case report, literature review and practical approach

Clinica Terapeutica

Volumn 163, Issue 1, 2012, Pages 59-62

  Tonolini, M ^a  

^a UNIVERSITY OF MILAN   (Italy)

Author keywords

Computed tomography (CT); Diabetes mellitus; Iodine based contrast agent; Lactic acidosis; Metformin

Indexed keywords

BICARBONATE; INSULIN; IODINATED CONTRAST MEDIUM; METFORMIN;

AGED; ATELECTASIS; BRONCHUS OBSTRUCTION; CARDIOVASCULAR DISEASE; CASE REPORT; COMORBIDITY; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; DIABETES MELLITUS; DRUG ABSORPTION; DRUG CONTRAINDICATION; DRUG EXCRETION; DRUG HALF LIFE; DRUG MECHANISM; DRUG METABOLISM; DRUG SUBSTITUTION; DRUG WITHDRAWAL; DYSPNEA; FEMALE; FEVER; HEART ATRIUM FIBRILLATION; HEMODIALYSIS; HEMOFILTRATION; HUMAN; HYPOVENTILATION; KIDNEY FAILURE; LABORATORY TEST; LACTIC ACIDOSIS; LUNG EMBOLISM; MULTIDETECTOR COMPUTED TOMOGRAPHY; PNEUMONIA; RESPIRATORY DISTRESS; RESPIRATORY TRACT DISEASE; REVIEW; SEPSIS; TACHYPNEA; THORAX RADIOGRAPHY;

ACIDOSIS, LACTIC; AGED, 80 AND OVER; ATRIAL FIBRILLATION; CONTRAST MEDIA; CREATININE; DIABETES MELLITUS, TYPE 2; EMERGENCIES; FATAL OUTCOME; FEMALE; HEART FAILURE; HUMANS; HYPERTENSION; HYPOGLYCEMIC AGENTS; IODINE COMPOUNDS; KIDNEY; KIDNEY DISEASES; METFORMIN; PULMONARY ATELECTASIS; RENAL DIALYSIS; SMOKING; TOMOGRAPHY, SPIRAL COMPUTED;

EID: 84858437122     PISSN: 00099074     EISSN: 19726007     Source Type: Journal    
DOI: None     Document Type: Review

References (24)

1. Philbrick AM, Ernst ME, McDanel DL, et al. Metformin use in renal dysfunction: is a serum creatinine threshold appropriate? Am J Health Syst Pharm 2009; 66:2017-23
2. Seidowsky A, Nseir S, Houdret N, Fourrier F. Metforminassociated lactic acidosis: a prognostic and therapeutic study. Crit Care Med 2009; 37:2191-6
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 Syst Rev 2010; CD002967
4. Howlett HC, Bailey CJ. A risk-benefit assessment of metformin in type 2 diabetes mellitus. Drug Saf 1999; 20:489-503
5. Abbasi AA, Kasmikha R, Sotingeanu DG. Metformin-induced lacticacidemia in patients with type 2 diabetes mellitus. Endocr Pract 2000; 6:442-6
6. Bruijstens LA, van Luin M, Buscher-Jungerhans PM, et al. Reality of severe metformin-induced lactic acidosis in the absence of chronic renal impairment. Neth J Med 2008; 66:185-90
7. Devetzis V, Passadakis P, Panagoutsos S, et al. Metforminrelated lactic acidosis in patients with acute kidney injury. Int Urol Nephrol 2010
8. Di Grande A, Vancheri F, Giustolisi V, et al. Metformininduced lactic acidosis in a type 2 diabetic patient with acute renal failure. Clin Ter 2008;159:87-9
9. Lalau JD. Lactic acidosis induced by metformin: incidence, management and prevention. Drug Saf 2010; 33:727-40
10. Lalau JD, Race JM. Lactic acidosis in metformin-treated patients. Prognostic value of arterial lactate levels and plasma metformin concentrations. Drug Saf 1999; 20:377-84
11. Runge S, Mayerle J, Warnke C, et al. Metformin-associated lactic acidosis in patients with renal impairment solely due to drug accumulation? Diabetes Obes Metab 2008; 10:91-3
12. Scale T HJ. Diabetes, metformin and lactic acidosis. Clin Endocrinol (Oxf) 2010
13. Stang M, Wysowski DK, Butler-Jones D. Incidence of lactic acidosis in metformin users. Diabetes Care 1999; 22:925-7
14. Goergen SK RG, Compton G, Harris C. Systematic review of current guidelines, and their evidence base, on the risk of lactic acidosis after administration of contrast medium for patients receiving metformin. Radiol 2010; 254:261-8
15. Nawaz S, Cleveland T, Gaines PA, et al. Clinical risk associated with contrast angiography in metformin treated patients: a clinical review. Clin Radiol 1998; 53:342-4
16. Thomsen HS, Morcos SK. Contrast media and metformin: guidelines to diminish the risk of lactic acidosis in noninsulin-dependent diabetics after administration of contrast media. ESUR Contrast Media Safety Committee. Eur Radiol 1999; 9:738-40
17. Thomsen HS, Morcos SK, Almen T, et al. Metformin and contrast media. Radiol 2010; 256:672-673; author reply 673
18. Holstein A, Stumvoll M. Contraindications can damage your health-is metformin a case in point? Diabetol 2005; 48:2454-9
19. Lalau JD, Westeel PF, Debussche X, et al. Bicarbonate haemodialysis: an adequate treatment for lactic acidosis in diabetics treated by metformin. Intensive Care Med 1987; 13:383-7
20. Thomsen HS, Morcos SK. In which patients should serum creatinine be measured before iodinated contrast medium administration? Eur Radiol 2005; 15:749-54
21. ESUR Guidelines on Contrast Media 7.0. European Society of Urogenital Radiology Web site. http://www.esur.org/Contrast - media.51.0.html. Published March 2009. Accessed February 18, 2011
22. Morcos SK, Thomsen HS, Webb JA. Contrast-media-induced nephrotoxicity: a consensus report. Contrast Media Safety Committee, European Society of Urogenital Radiology (ESUR). Eur Radiol 1999; 9:1602-13
23. Ashley JB, Millward SF. Contrast agent-induced nephropathy: a simple way to identify patients with preexisting renal insufficiency. AJR Am J Roentgenol 2003; 181:451-4
24. Herts BR, Schneider E, Poggio ED, et al. Identifying outpatients with renal insufficiency before contrast-enhanced CT by using estimated glomerular filtration rates versus serum creatinine levels. Radiol 2008; 248:106-13