Metformin-related lactic acidosis: is it a myth or an underestimated reality?

Renal Failure

Volumn 38, Issue 9, 2016, Pages 1560-1565

  Visconti, Luca ^a   Cernaro, Valeria ^a   Ferrara, Domenico ^b   Costantino, Giuseppe ^a   Aloisi, Carmela ^a   Amico, Luisa ^b   Chirico, Valeria ^c   Santoro, Domenico ^a   Noto, Alberto ^c   David, Antonio ^c   Buemi, Michele ^a   Lacquaniti, Antonio ^a  

^a UNIVERSITY OF MESSINA   (Italy)

^b Pediatria II   (Italy)

^c UNIVERSITY OF MESSINA   (Italy)

Author keywords

acute kidney injury; continuous renal replacement therapy; hemodialysis; lactic acidosis; metformin; Metformin associated lactic acidosis (MALA)

Indexed keywords

BICARBONATE; INSULIN; LACTIC ACID; METFORMIN; PLACEBO; ANTIDIABETIC AGENT;

ARTICLE; CHRONIC KIDNEY FAILURE; CLINICAL ASSESSMENT; DIABETIC PATIENT; DRUG BLOOD LEVEL; DRUG ELIMINATION; DRUG INDUCED DISEASE; DRUG SAFETY; EMERGENCY WARD; HUMAN; INCIDENCE; INTENSIVIST; KIDNEY FUNCTION; LACTATE BLOOD LEVEL; LACTIC ACIDOSIS; METABOLIC ACIDOSIS; METFORMIN ASSOCIATED LACTIC ACIDOSIS; NEPHROLOGIST; NON INSULIN DEPENDENT DIABETES MELLITUS; PATHOPHYSIOLOGY; PLASMA; PRIORITY JOURNAL; PROGNOSIS; RANDOMIZED CONTROLLED TRIAL (TOPIC); RENAL REPLACEMENT THERAPY; CHEMICALLY INDUCED; COMPLICATION; DIABETES MELLITUS, TYPE 2; RENAL INSUFFICIENCY; RISK FACTOR;

ACIDOSIS, LACTIC; DIABETES MELLITUS, TYPE 2; HUMANS; HYPOGLYCEMIC AGENTS; METFORMIN; RENAL INSUFFICIENCY; RENAL REPLACEMENT THERAPY; RISK FACTORS;

EID: 84981194100     PISSN: 0886022X     EISSN: 15256049     Source Type: Journal    
DOI: 10.1080/0886022X.2016.1216723     Document Type: Article

References (35)

1. P.Y.Guo, L.J.Storsley, S.N.Finkle Severe lactic acidosis treated with prolonged hemodialysis:Recovery after massive overdoses of metformin. Semin Dial. 2006;19:80–83.
2. A.Frid, G.N.Sterner, M.Löndahl,. Novel assay of metformin levels in patients with type 2 Diabetes and varying levels of renal function:Clinical recommendations. Diabetes Care. 2010;33:1291–1293.
3. A.Badawy, A.Elnashar Treatment options for polycystic ovary syndrome. Int J Womens Health. 2011;3:25–35.
4. G.Bellinghieri, A.Bernardi, M.Piva,. Metabolic syndrome after kidney transplantation. J Ren Nutr. 2009;19:105–110.
5. A.I.Morales, D.Detaille, M.Prieto,. Metformin prevents experimental Gentamicin-Induced Nephropathy by a mitochondria-dependent pathway. Kidney Int. 2010;77:861–869.
6. A.J.Scheen, N.Paquot Metformin revisited:A critical review of the benefit-risk balance in at-risk patients with type 2 diabetes. Diabetes Metab. 2013;39:179–190.
7. J.D.Lalau, J.M.Race. Lactic acidosis in metformin therapy:Searching for a link with metformin in reports of ‘metformin-associated lactic acidosis’. Diabetes Obes Metab. 2001;3:195–201.
8. J.D.Lalau Lactic acidosis induced by metformin:Incidence, management and prevention. Drug Saf. 2010;33:727–740.
9. J.H.Scarpello, H.C.Howlett Metformin therapy and clinical uses. Diab Vasc Dis Res. 2008;5:157–167.
10. A.Rocha, M.Almeida, J.Santos,. Metformin in patients with chronic kidney disease:Strengths and weaknesses. J Nephrol. 2013;26:55–60.
11. S.R.Salpeter, E.Greyber, G.A.Pasternak,. Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus. Cochrane Database Syst Rev. 2010;(4):CD002967.
12. S.Vecchio, A.Protti Metformin-induced lactic acidosis:No one left behind. Crit Care. 2011;15:107.
13. D.Klachko, A.Whaley-Connell Use of metformin in patients with kidney and cardiovascular diseases. Cardiorenal Med. 2011;1:87–95.
14. H.L.Pilmore. Review:Metformin:Potential benefits and use in chronic kidney disease. Nephrology. 2010;15:412–418.
15. H.J.Nye, W.G.Herrington Metformin:The safest hypoglycaemic agent in chronic kidney disease? Nephron Clin Pract. 2011;118:380–383.
16. R.R.Holman, S.K.Paul, M.A.Bethel, D.R.Matthews, H.A.W.Neil 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359:1577–1589.
17. A.Kooy, J.Jager, P.Lehert,. Long term effects of metformin on metabolism and microvascular and macrovascular disease in patients with type 2 diabetes mellitus. Arch Intern Med. 2009;169:616–625.
18. S.Vecchio, A.Giampreti, V.M.Petrolini,. Metformin accumulation:Lactic acidosis and high plasmatic metformin levels in a retrospective case series of 66 patients on chronic therapy. Clin Toxicol (Phila). 2014;52:129–135.
19. F.Renda, P.Mura, G.Finco,. Metformin-associated lactic acidosis requiring hospitalization. A national 10 year survey and a systematic literature review. Eur Rev Med Pharmacol Sci. 2013;17:45–49 [Database].
20. A.Spiller, D.A.Quadrani Toxic effects from metformin exposures. Ann Pharmacother. 2004;38:776–780.
21. S.A.Al-Abri, S.Hayashi, K.L.Thoren, K.R.Olson Metformin overdose-induced hypoglycemia in the absence of other antidiabetic drugs. Clin Toxicol (Phila). 2013;51:444–447.
22. G.Zhou, R.Myers, Y.Li,. Role of AMP-activated protein kinase in mechanism of metformin action. J Clin Invest. 2001;108:1167–1174.
23. A.Protti, A.Lecchi, F.Fortunato,. Metformin overdose causes platelet mitochondrial dysfunction in humans. Crit Care. 2012;16:R180.
24. G.G.Graham, J.Punt, M.Arora,. Clinical pharmacokinetics of metformin. Clin Pharmacokinet. 2011;50:81–98.
25. J.D.Lalau, C.Lacroix Measurement of metformin concentration in erythrocytes:Clinical implications. Diabetes Obes Metab. 2003;5:93–98.
26. J.Perrone, C.Phillips, D.Gaieski Occult metformin toxicity in three patients with profound lactic acidosis. J Emerg Med. 2011;40:271–275.
27. L.T.Pan, G.Maclaren. Continuous venovenous haemodiafiltration for metformin-induced lactic acidosis. Anaesth Intensive Care. 2009;37:830–832.
28. M.Buemi, A.Lacquaniti, D.Bolignano,. Dialysis and the elderly:An underestimated problem. Kidney Blood Press Res. 2008;31:330–336.
29. N.C.Sambol, J.Chiang, M.O’Conner, C.Y.Liu, E.T.Lin,. Pharmacokinetics and pharmacodynamics of metformin in healthy subjects and patients with noninsulin-dependent diabetes mellitus. J Clin Pharmacol. 1996;36:1012–1021.
30. S.C.Gan, J.Barr, A.I.Arieff, R.G.Pearl Biguanide-associated lactic acidosis. Case report and review of the literature. Arch Intern Med. 1992;152:2333–2336.
31. A.Seidowsky, S.Nseir, N.Houdret,. Metformin-associated lactic acidosis:A prognostic and therapeutic study. Crit Care Med. 2009;37:2191–2196.
32. H.Nguyen Metformin intoxication requiring dialysis. Hemodial Int. 2011;15:S68–S71.
33. G.Keller, M.Cour, R.Hernu,. Management of metformin-associated lactic acidosis by continuous renal replacement therapy. PLoS One. 2011;6:e23200.
34. A.Lacquaniti, V.Donato, B.Pintaudi,. “Normoalbuminuric” diabetic nephropathy:tubular damage and NGAL. Acta Diabetol. 2013;50:935–942.
35. D.R.Cryer, S.P.Nicholas, D.H.Henry,. Comparative outcomes study of metformin intervention versus conventional approach the COSMIC Approach Study. Diabetes Care. 2005;28:539–543.