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[Metformin- related lactic acidosis].

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    Summary

    Metformin-related lactic acidosis is a serious condition requiring nephrological expertise. Hemodiafiltration effectively treated two elderly patients with severe lactic acidosis and acute kidney injury.

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    Area of Science:

    • Nephrology
    • Toxicology
    • Internal Medicine

    Background:

    • Metformin-related lactic acidosis is a severe, potentially fatal complication of metformin therapy.
    • While prevalence is stable, effective management requires specialized nephrological knowledge.
    • Acute kidney injury (AKI) is a common comorbidity in patients with lactic acidosis.

    Observation:

    • Two elderly patients presented with severe lactic acidosis and concurrent acute renal failure.
    • Both patients had a history of metformin use.
    • The clinical presentation indicated a critical state requiring intensive intervention.

    Findings:

    • Hemodiafiltration was employed as the primary therapeutic strategy for both patients.
    • The treatment aimed to correct acidosis and remove metformin and its toxic metabolites.
    • Successful management of lactic acidosis and AKI was achieved through hemodiafiltration.

    Implications:

    • This case series highlights the critical role of nephrologists in managing metformin-related lactic acidosis.
    • Hemodiafiltration emerges as a viable and effective treatment modality for this complex condition.
    • Prompt and aggressive renal replacement therapy is crucial for improving outcomes in severe cases.