SciELO - Scientific Electronic Library Online

 
vol.31 issue9Early interruption of clinical trials: too good to be true? author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google

Share


Medicina Intensiva

Print version ISSN 0210-5691

Abstract

ORTEGA CARNICER, J. et al. Overdose of metformin secondary to acute renal insufficiency: a report of six cases. Med. Intensiva [online]. 2007, vol.31, n.9, pp.521-525. ISSN 0210-5691.

Metformin is a biguanide used in the treatment of obese adults with type 2 diabetes mellitus; metformin decreases mortality by 36% in comparison to conventional treatment. Metformin administration has certain contraindications that, when ignored, especially in the case of acute renal insufficiency, leads to the accumulation of the drug and consequent lactic acidosis that can be fatal. We present 6 patients with acute renal insufficiency that experienced extreme acute metabolic acidosis (pH < 6.90 and bicarbonate < 5 mEq/l) and increased anion gap while receiving metformin for the treatment of diabetes. Serum lactic acid, only evaluated in the 4 patients that survived, was high. Two patients died after cardiac arrest that could have been avoided. In conclusion, lactic acidosis appearing during metformin treatment for diabetes requires rapid diagnosis and treatment to enable the drug to be withdrawn and prolonged continuous hemofiltration or hemodialysis with bicarbonate to be initiated.

Keywords : metformin; kidney failure; lactic acidosis; anion gap; diabetes.

        · abstract in Spanish     · text in Spanish

 

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License