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Acute renal failure and lactic acidosis seconder to metformin intoxication

Year 2022, , 379 - 382, 01.04.2022
https://doi.org/10.31362/patd.900939

Abstract

Metformin is a oral antidiabetic drug being class of biguanid. It reduces hepatic glucose production by inhibiting gluconeogenesis, improves peripheral insulin sensivity. The well known serious side effects are acute renal failure and lactic asidosis. Metformin is the most commonly prescribed drug because of its cost-effectiveness and existing in first line theraphy in guidelines for type 2 diabetes mellitus. We report a case a patient with known hypertension and new diagnosis diabetes mellitus, presenting acute renal failure and lactic acidosis seconder to taking overdose metformin in suicide attempt.

References

  • 1-Momenzadeh M, Lakkakuka B.VKS. Metformin induced acute kidney injury; a systematic review. J. Nephropharmacol 2021; 10(2): 13. https://doi.10.34172/npj.2021.13.
  • 2- Corremans R, Vervaet B.A, D’haese P.C., Neven E, Verhulst A. Metformin: A candidate drug for renal diseases. Int J Mol Sci 2019; 20: 42. https://doi.10.3390/ijms20010042.
  • 3- Lashen H. Role of metformin in the management of polycystic ovary syndrome. Ther Adv Endocrinol. Metab 2010; 1: 117-128. https://doi. 10.1177/2042018810380215.
  • 4- Li YAN, Liu LEI, Wang BIN, Wang JUN, Chen D. metformin in non-alcoholic fatty liver disease: A systematic review and meta-analysis. Biomed Rep 2013; 1: 57-64.https://doi: 10.3892/br.2012.18.
  • 5- Ibanez L, Ong K, Valls C, Marcos MV, Dunger DB, De Zegher F. Metformin treatment to prevent early puberty in girls with precocious pubarche. J Clin Endocrinol Metab 2006;91: 2888-2891. https:// doi: 10.1210/jc.2006-0336.
  • 6- DeFronzo R, Fleming GA, Chen K, Bicsak TA. Metformin-associated lactic acidosis: current perspectives on causes and risk. Metabolism Clinical and Experimental 2016; 65: 20-29. https:// doi: 10.1016/j.metabol.2015.10.014
  • 7- Chan NN, Brain HP, Feher MD. Metformin-associated lactic acidosis: a rare or very rare clinical entity? Diabet Med 1999; 16: 273-281. https:// doi: 10.1046/j.1464-5491.1999.00006.x.
  • 8- Inzucchi SE, Lipska KJ, Mayo H, Bailey CJ, McGuire DK. Metformin in patients with Type 2 Diabetes and Kidney Disease: A systematic Review. JAMA 2014: 312(24): 2668-2675. https:// doi: 10.1001/jama.2014.15298.
  • 9- Angioi A, Cabiddu G, Conti M, et al. Metformin associated lactic acidosis: a case series of 28 patients treated with sustained low-efficiency dialysis (SLED) and long-term follow-up. BMC Nephrology 2018; 19: 77. https:// doi: 10.1186/s12882-018-0875-8.
  • 10- Kinoshita H, Yanai M, Ariyoshi K, Ando M, Tamura R. A patients with metformin-associated lactic acidosis successfully treated with continuous renal replacement theraphy: a case report. Journal of Medical Case Reports 2019; 13: 371. https:// doi: 10.1186/s13256-019-2311-5.
  • 11- Arroyo D, Melero R, Panizo N, et al. Metformin-associated acute kidney injury and lactic acidosis. Int. J. of Nephrology 2011;2011:5. https://doi:10.4061/2011/749653
  • 12- Kocaoğlu Ç, Özel A. Metformin intoksikasyonuna bağlı akut böbrek yetmezliği: olgu sunumu. J Turk Soc Intensive Care 2018; 16: 76-78. https:// doi: 10.4274/tybd.26818

Metformin intoksikasyonuna sekonder gelişen akut böbrek hasarı ve laktik asidoz

Year 2022, , 379 - 382, 01.04.2022
https://doi.org/10.31362/patd.900939

Abstract

Metformin biguanid sınıfına ait bir oral antidiyabetik ajandır. Hepatik glukoneogenezi inhibe ederek glukoz üretimini azaltır; periferal dokularda insulin duyarlılığını düzeltir. Bilinen en korkulan yan etkisi laktik asidoz ve akut böbrek hasarıdır. Metformin gerek ucuz olması gerek ise diyabet tedavi kılavuzlarında ilk sıralarda yer alması nedeniyle diyabet tanılı hastalarda oldukça sık kullanılan bir ilaçtır. Bu olgu sunusunda bilinen hipertansif bir hastada yeni diyabet tanısı ile metformin tedavisine başlanmasından bir kaç ay sonra intihar amaçlı yüksek doz metformin alımına sekonder gelişen laktik asidoz ve akut böbrek hasarlı bir olgu anlatılmaktadır.

References

  • 1-Momenzadeh M, Lakkakuka B.VKS. Metformin induced acute kidney injury; a systematic review. J. Nephropharmacol 2021; 10(2): 13. https://doi.10.34172/npj.2021.13.
  • 2- Corremans R, Vervaet B.A, D’haese P.C., Neven E, Verhulst A. Metformin: A candidate drug for renal diseases. Int J Mol Sci 2019; 20: 42. https://doi.10.3390/ijms20010042.
  • 3- Lashen H. Role of metformin in the management of polycystic ovary syndrome. Ther Adv Endocrinol. Metab 2010; 1: 117-128. https://doi. 10.1177/2042018810380215.
  • 4- Li YAN, Liu LEI, Wang BIN, Wang JUN, Chen D. metformin in non-alcoholic fatty liver disease: A systematic review and meta-analysis. Biomed Rep 2013; 1: 57-64.https://doi: 10.3892/br.2012.18.
  • 5- Ibanez L, Ong K, Valls C, Marcos MV, Dunger DB, De Zegher F. Metformin treatment to prevent early puberty in girls with precocious pubarche. J Clin Endocrinol Metab 2006;91: 2888-2891. https:// doi: 10.1210/jc.2006-0336.
  • 6- DeFronzo R, Fleming GA, Chen K, Bicsak TA. Metformin-associated lactic acidosis: current perspectives on causes and risk. Metabolism Clinical and Experimental 2016; 65: 20-29. https:// doi: 10.1016/j.metabol.2015.10.014
  • 7- Chan NN, Brain HP, Feher MD. Metformin-associated lactic acidosis: a rare or very rare clinical entity? Diabet Med 1999; 16: 273-281. https:// doi: 10.1046/j.1464-5491.1999.00006.x.
  • 8- Inzucchi SE, Lipska KJ, Mayo H, Bailey CJ, McGuire DK. Metformin in patients with Type 2 Diabetes and Kidney Disease: A systematic Review. JAMA 2014: 312(24): 2668-2675. https:// doi: 10.1001/jama.2014.15298.
  • 9- Angioi A, Cabiddu G, Conti M, et al. Metformin associated lactic acidosis: a case series of 28 patients treated with sustained low-efficiency dialysis (SLED) and long-term follow-up. BMC Nephrology 2018; 19: 77. https:// doi: 10.1186/s12882-018-0875-8.
  • 10- Kinoshita H, Yanai M, Ariyoshi K, Ando M, Tamura R. A patients with metformin-associated lactic acidosis successfully treated with continuous renal replacement theraphy: a case report. Journal of Medical Case Reports 2019; 13: 371. https:// doi: 10.1186/s13256-019-2311-5.
  • 11- Arroyo D, Melero R, Panizo N, et al. Metformin-associated acute kidney injury and lactic acidosis. Int. J. of Nephrology 2011;2011:5. https://doi:10.4061/2011/749653
  • 12- Kocaoğlu Ç, Özel A. Metformin intoksikasyonuna bağlı akut böbrek yetmezliği: olgu sunumu. J Turk Soc Intensive Care 2018; 16: 76-78. https:// doi: 10.4274/tybd.26818
There are 12 citations in total.

Details

Primary Language Turkish
Subjects Urology
Journal Section Case Report
Authors

Halil Aydar 0000-0003-4431-3482

Neslihan Tezcan This is me 0000-0002-6525-6088

Rüya Mutluay 0000-0002-7159-0082

Publication Date April 1, 2022
Submission Date March 22, 2021
Acceptance Date October 27, 2021
Published in Issue Year 2022

Cite

AMA Aydar H, Tezcan N, Mutluay R. Metformin intoksikasyonuna sekonder gelişen akut böbrek hasarı ve laktik asidoz. Pam Tıp Derg. April 2022;15(2):379-382. doi:10.31362/patd.900939
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