Open AccessEarly and prolonged continuous hemodiafiltration for the treatment of severe metformin‐associated lactic acidosis
Author(s) -
Abramo Antonio,
Corini Marzia,
Malacarne Paolo,
Donadio Francesca,
Donadio Carlo
Publication year - 2009
Publication title -
dialysis & transplantation
Language(s) - English
Resource type - Journals
eISSN - 1932-6920
pISSN - 0090-2934
DOI - 10.1002/dat.20318
Subject(s) - medicine , lactic acidosis , metformin , acidosis , sodium bicarbonate , coma (optics) , shock (circulatory) , rhabdomyolysis , metabolic acidosis , renal replacement therapy , anesthesia , bicarbonate , surgery , insulin , chemistry , physics , optics
In this article, we discuss the case of a 42‐year‐old female diabetic patient who developed severe lactic acidosis, coma, shock, rhabdomyolysis, and renal and hepatic failure during metformin therapy after alcohol abuse. The APACHE II score of this patient was 38, which is associated with an estimated mortality rate >88%. Conventional treatment of acidosis with IV infusion of sodium bicarbonate (400 mmol) was ineffective in restoring a normal acid/base balance. Lactic acidosis was successfully treated with bicarbonate‐buffered continuous veno‐venous hemodiafiltration. The patient also had a complete recovery from all complications.