Hemodialysis for phenformin associated lactic acidosis.

A patient who attempted suicide by ingesting a large amount of phenformin developed a severe lactic acidosis. After receiving hemodialysis on two successive days, she recovered without sequela. On both occasions, the dialyses temporarily improved the degree of acidosis. The amount of phenformin extracted during these two procedures was measured and found to be only 1.5% of the total amount of drug ingested. Therefore, it is felt that hemodialysis does not remove the offending drug but does play a supportive role in the management of these patients by temporarily ameliorating some of the biochemical abnormalities.