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Lactic acidosis with phenformin therapy.

T Cleaver, R Carretta

    California Medicine
    |July 1, 1972
    PubMed
    Summary
    This summary is machine-generated.

    Phenformin therapy in maturity onset diabetes patients with renal disease can lead to severe lactic acidosis. Unrecognized kidney function decline is a key factor in developing this dangerous condition.

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    Area of Science:

    • Endocrinology
    • Nephrology
    • Pharmacology

    Background:

    • Phenformin was a widely used oral antihyperglycemic agent for type 2 diabetes.
    • Lactic acidosis is a rare but serious adverse effect associated with phenformin.
    • Patients with diabetes, particularly those with impaired renal function, are at higher risk.

    Purpose of the Study:

    • To review cases of severe lactic acidosis in patients with maturity onset diabetes on phenformin.
    • To identify contributing factors, treatment, and prevention strategies for phenformin-induced lactic acidosis.
    • To highlight the role of renal disease in the development of lactic acidosis.

    Main Methods:

    • Retrospective review of nine patient cases.
    • Analysis of clinical data, laboratory results (including blood lactate levels), and patient history.

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  • Evaluation of contributing factors and treatment outcomes.

    • Main Results:

    • All nine patients had maturity onset diabetes and were on phenformin therapy.
    • All patients presented with severe acidosis, with lactic acidosis confirmed in seven.
    • Evidence of renal disease was present in all cases, implicating declining renal function.
    • Contributing factors, treatment, and prevention were discussed.

    Conclusions:

    • Severe lactic acidosis is a significant risk associated with phenformin, especially in diabetic patients with renal impairment.
    • Unrecognized progressive deterioration of renal function is strongly implicated in the etiology of phenformin-induced lactic acidosis.
    • Vigilance for renal function and careful patient selection are crucial for preventing this adverse event.