Should dialysis be offered in all cases of metformin-associated lactic acidosis?

Metformin is commonly used in diabetes mellitus type 2, with lactic acidosis being a rare but potentially fatal complication of this therapy. The management of metformin-associated lactic acidosis (MALA) is controversial. Treatment may include supportive care, activated charcoal, bicarbonate infusio...

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Veröffentlicht in:	Critical care (London, England) England), 2009, Vol.13 (1), p.110-110
1. Verfasser:	Finkle, S Neil
Format:	Artikel
Sprache:	eng
Schlagworte:	Acidosis, Lactic - chemically induced Acidosis, Lactic - therapy Animals Humans Metformin - adverse effects Renal Dialysis - methods
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description	Metformin is commonly used in diabetes mellitus type 2, with lactic acidosis being a rare but potentially fatal complication of this therapy. The management of metformin-associated lactic acidosis (MALA) is controversial. Treatment may include supportive care, activated charcoal, bicarbonate infusion, hemodialysis, or continuous venovenous hemofiltration. In the previous issue of Critical Care, Peters and colleagues systematically evaluated outcomes in MALA patients admitted to their intensive care unit. The mortality rate of patients who received dialysis was similar to that of patients who were not dialyzed. However, it was the more acutely and chronically ill patients who actually received dialysis. This suggests that hemodialysis was beneficial in preventing a higher mortality rate in those who required renal replacement therapy.
doi_str_mv	10.1186/cc7161
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subjects	Acidosis, Lactic - chemically induced Acidosis, Lactic - therapy Animals Humans Metformin - adverse effects Renal Dialysis - methods
title	Should dialysis be offered in all cases of metformin-associated lactic acidosis?
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