Almaleki Najlaa, Ashraf Mohammad, Hussein Majdi M, Mohiuddin Syed A
Al Hada Armed Forces Hospital, Al Hada, Taif, Saudi Arabia.
Saudi J Kidney Dis Transpl. 2015 Mar;26(2):325-8. doi: 10.4103/1319-2442.152498.
Metformin is one of the commonly used drugs in type-2 diabetes mellitus. It reduces glucose levels by increasing insulin sensitivity, reducing hepatic glucose release and increasing muscle uptake. One of the serious complications associated with metformin use is lactic acidosis, and it is associated with high morbidity and mortality. This is more likely to happen in patients with renal failure due to reduced clearance. International guidelines recommend discontinuing metformin in advanced renal failure. We report a case of metformin-associated lactic acidosis in a patient with end-stage renal disease on peritoneal dialysis. The patient presented with severe lactic acidosis, which was successfully treated with hemodialysis.
二甲双胍是2型糖尿病常用药物之一。它通过提高胰岛素敏感性、减少肝脏葡萄糖释放和增加肌肉摄取来降低血糖水平。与使用二甲双胍相关的严重并发症之一是乳酸酸中毒，且其发病率和死亡率都很高。由于清除率降低，这种情况在肾衰竭患者中更易发生。国际指南建议在晚期肾衰竭时停用二甲双胍。我们报告一例接受腹膜透析的终末期肾病患者发生二甲双胍相关性乳酸酸中毒的病例。该患者出现严重乳酸酸中毒，经血液透析成功治疗。
