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Metformin-associated lactic acidosis precipitated by diarrhea
Adel S El-Hennawy1, Sunitha Jacob, Aza K Mahmood
1Nephrology and Dialysis Center, Renal Division, Coney Island Hospital, Brooklyn, NY, USA. goodkidneys@aol.com
Abstract:
Metformin-associated lactic acidosis (MALA) is a serious metabolic complication that occurs because of metformin accumulation in patients who become dehydrated or developed acute renal failure. Bicarbonate hemodialysis treatment should take place early in the course of management, especially in patients with severe metabolic acidosis who fail to respond to intravenous bicarbonate therapy or in whom renal failure is present. We report a case of MALA in which acute renal failure resulting from dehydration secondary to diarrhea and poor oral intake likely caused MALA. Early recognition of this condition and initiation of effective treatment can improve outcome.
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