Retrospective evaluation of management guidelines for extracorporeal treatment of metformin poisoning

Keywords： metformin, lactic acidosis, MALA, prolonged hemodialysis, thiamine 〈Abstract〉 Metformin is widely used as a treatment for type 2 diabetes. Although it is extremely rare, metformin associated lactic acidosis (MALA) is a serious side effect. MALA requires prompt treatment due to its high fatality rate. Herein, we report a case of MALA in a 59 year old woman with normal renal function that developed after Campylobacter jejuni enteritis and was successfully treated with prolonged hemodialysis. In general, hemodialysis is recommended over continuous hemodiafiltration because of its higher clearance if the patientʼs blood pressure can be maintained. On the other hand, there is a concern that prolonged hemodialysis may result in the removal of vitamins and other necessary components of the body. Therefore, we supplemented thiamine as needed and used an antibiotic that is not easily removed by hemodialysis. The patient had a history of epileptic seizure due to failure to take antiepileptic drugs. For this reason, she was committed to strict adherence to her medications and continued to take them even on days when she felt sick. When we start metformin prescriptions, it is essential to provide appropriate medication guidance to prevent serious complications.

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Retrospective evaluation of management guidelines for extracorporeal treatment of metformin poisoning

Cited by 2 publications

References 9 publications

Expanding the evidence for managing metformin poisoning to support decision-making

Expanding the evidence for managing metformin poisoning to support decision-making

<i>Campylobacter jejuni</i> 腸炎を契機に発症したメトホルミン関連乳酸アシドーシスに対し，長時間の血液透析を施行し救命した1例

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