Achieving High Dialysis Dose via Continuous Renal Replacement Therapy in the Setting of Metformin Associated Lactic Acidosis. A Case Series

Severe and life-threatening cases of metformin-associated lactic acidosis (MALA) are treated with renal replacement therapy. Intermittent hemodialysis is recommended, as it achieves rapid more elimination of metformin compared to continuous renal replacement therapy (CRRT). This case series describe...

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Bibliographic Details
Published in:	A&A practice Vol. 16; no. 1; p. e01561
Main Authors:	Reynolds, Hannah V., Pollock, Hamish H. G., Apte, Yogesh V., Tabah, Alexis
Format:	Journal Article
Language:	English
Published:	United States Lippincott Williams & Wilkins 18-01-2022
Subjects:	Acidosis, Lactic - chemically induced Acidosis, Lactic - therapy Case Series Continuous Renal Replacement Therapy Humans Hypoglycemic Agents - adverse effects Metformin - adverse effects Renal Dialysis
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Summary:	Severe and life-threatening cases of metformin-associated lactic acidosis (MALA) are treated with renal replacement therapy. Intermittent hemodialysis is recommended, as it achieves rapid more elimination of metformin compared to continuous renal replacement therapy (CRRT). This case series describes 4 patients, 2 with acute metformin intoxications and 2 with insidious metformin toxicity. All were treated using a novel approach with dual CRRT to achieve rapid elimination of metformin. Three of the 4 patients survived to hospital discharge. Dual CRRT may be an effective alternative when dialysis is not readily available.
ISSN:	2575-3126 2575-3126
DOI:	10.1213/XAA.0000000000001561