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使用静脉注射X线造影剂后,2型糖尿病患者接受二甲双胍治疗时的肾毒性

[Nephrotoxicity after the use of intravenous X-ray contrast media in a type 2 diabetic being treated with metformin].

作者信息

Bjarnason Nina Hannover, Elung-Jensen Thomas

机构信息

H:S Rigshospitalet, Klinisk Farmakologisk Afdeling Q, København.

出版信息

Ugeskr Laeger. 2006 May 1;168(18):1772-3.

Abstract

Contrast media may induce nephrotoxicity, particularly in elderly patients with pre-existing renal impairment. The concomitant use of metformin may lead to lactic acidosis due to metformin accumulation. Thus, metformin should be discontinued prior to use of contrast media. We observed acute renal failure requiring haemodialysis in a 74-year-old man with non-insulin-dependent type II diabetes. The man had had an intravenous urography to examine an increased plasma creatinine level, and metformin had not been discontinued. We report the case to remind doctors of this avoidable side effect.

摘要

造影剂可能会诱发肾毒性,尤其是在已有肾功能损害的老年患者中。同时使用二甲双胍可能会因二甲双胍蓄积导致乳酸性酸中毒。因此,在使用造影剂之前应停用二甲双胍。我们观察到一名74岁非胰岛素依赖型II型糖尿病男性发生了需要血液透析的急性肾衰竭。该男子因血浆肌酐水平升高接受了静脉肾盂造影,且未停用二甲双胍。我们报告此病例以提醒医生注意这种可避免的副作用。

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