Related Experiment Video
Updated: Mar 7, 2026
05:09
Long-Term Continuous Measurement of Renal Blood Flow in Conscious Rats
Published on: February 8, 2022
3.1K
Metformin-associated lactic acidosis treated with continuous renal replacement therapy
Akihide Nakamura1,2, Kei Suzuki1,2, Hiroshi Imai2
1Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan.
BMJ Case Reports
|February 12, 2017
Summary
Metformin-associated lactic acidosis (MALA) is a rare emergency. Continuous renal replacement therapy (CRRT) effectively treated a severe MALA case, stabilizing the patient and normalizing lactate levels.
Area of Science:
- Nephrology
- Critical Care Medicine
- Pharmacology
Background:
- Metformin-associated lactic acidosis (MALA) is a rare, life-threatening condition.
- Early recognition and prompt management are crucial for patient survival.
Observation:
- A 71-year-old male presented with non-specific gastrointestinal symptoms, progressing to catecholamine-resistant shock and severe lactic acidosis.
- Standard treatments including bicarbonate and antibiotics provided no clear benefit.
Findings:
- Urgent continuous renal replacement therapy (CRRT) was initiated due to hemodynamic instability and metabolic acidosis.
- CRRT rapidly reduced lactate levels, with complete normalization of pH within 18 hours, leading to patient stabilization.
Implications:
- MALA can present with subtle, non-specific symptoms, necessitating consideration in cases of unexplained metabolic acidosis.
- CRRT is a valuable therapeutic option for severe MALA, especially in hemodynamically unstable patients.
- Emergency physicians must be familiar with MALA as a critical medical emergency.
Related Concept Videos
01:30Continuous Renal Replacement Therapy
1.5K
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
1.5K
01:26Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
300
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
300
01:20Acute Kidney Injury V: Interprofessional Care
436
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
436
01:28Chronic Kidney Disease III: Interprofessional Care
559
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
559
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
285
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
285
01:25Chronic Kidney Disease I: Introduction
912
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
912