Závažná laktátová acidóza provázená akutním renálním selháním u diabetičky léčené metforminem

Severe lactic acidosis associated with acute renal failure in a diabetic patient treated with metformin – A case study.

Lactic acidosis is a known adverse risk of metformin treatment. Here we have outlined a case in which lactic acidosis developed during treatment of a diabetic patient in whom there were no contraindications to metformin treatment. Lactic acidosis was caused by acute renal failure leading to metformin accumulation. The acute renal failure was caused by a combination of dehydration due to a low intake of fluids when disabled because of a fractured ankle, concomitant diuretic treatment of arterial hypertension and angiotensin-converting enzyme inhibitor treatment. The patient was successfully treated by a combination of haemodialysis and infusion therapy. We recommend that all patients on metformin should consider temporarily discontinuing treatment in the event of severe illness, including dehydration.

Key words:
lactic acidosis, metformin, renal failure, type 2 diabetes