Akut Böbrek Hasarı Olgusunda Metformin İle İlişkili Laktik Asidoz

Abstract

Aim:Metformin is an oral anti-diabetic agent recommended in the first-line treatment of type 2 diabetes. Although lactic acidosis is rarely observed, it is the most important side effect due to its high mortality rate. Hypoxemia, sepsis, acute and chronic renal injury, hepatic insufficiency and heart failure can precipitate metformin-associated lactic acidosis (MALA). Here, we aimed to discuss MALA in a case of acute kidney injury.Case: A 64-year-old female patient was hospitalized in the neurology department due to signs of parkinsonism and was consulted due to increased urea and creatinine. She had nausea, vomiting and loss of appetite. Her vital signs were stable. When questioned, it was learned that she had been receiving metformin treatment for diabetes mellitus for 6 years. High anion gap metabolic acidosis and lactic acid elevation were found in blood gas. The patient was considered to have MALA in the setting of acute kidney injury. Metformin was discontinued. Hemodialysis and supportive treatment was administered. Recovery of the patient's renal functions was achieved after a week.Result: Follow-up of patients treated with metformin in terms of contraindications is important to prevent the development of MALA. Early diagnosis, supportive treatment and renal replacement treatments reduce morbidity and mortality in MALA