ArticlePloS one2011
Management of metformin-associated lactic acidosis by continuous renal replacement therapy.
Article in PloS one, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Metformin's Role in Hyperlactatemia and Lactic Acidosis in ICU Patients: A Systematic Review.Pharmacology · 2023Pooled it
- Do Patients Die with or from Metformin-Associated Lactic Acidosis (MALA)? Systematic Review and Meta-analysis of pH and Lactate as Predictors of Mortality in MALA.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2020Pooled it
- The Association between Metformin Therapy and Lactic Acidosis.Drug safety · 2019Pooled it
- Kidney replacement therapy and mortality in metformin-associated lactic acidosis with acute kidney injury (2015-2021): a multi-year cohort study.Renal failure · 2025Article
- Risk of medication-induced lactic acidosis and hyperlactatemia: a pharmacovigilance study of the United States Food and Drug Administration's Adverse Event Reporting System database.Frontiers in pharmacology · 2025Article
- Metformin Toxicity Leading to Severe Refractory Hyperkalemia and Metabolic Acidosis: A Case Report.Cureus · 2024Article
- Combined lactic acidosis and ketoacidosis in a female diabetic patient with severe heart failure.Cardiovascular endocrinology & metabolism · 2023Article
- Clinical presentation of Warburg effect in aggressive lymphoma: a case report.Journal of medical case reports · 2023Article
- Unusual Case of Metformin-Associated Lactic Acidosis in Patient with Type 2 Diabetes Mellitus.The American journal of case reports · 2022Article
- Metformin, chronic nephropathy and lactic acidosis: a multi-faceted issue for the nephrologist.Journal of nephrology · 2021Review
- Continuous Renal Replacement Therapy (CRRT) for Nonrenal Indications among Critically Ill Children with Malignancy.Case reports in pediatrics · 2021Article
- Irrespective of the degree of hyperlactatemia, similar lactate levels were associated with a lower mortality rate in metformin users compared with non-users: beware of confounders!Annals of intensive care · 2020Article
- Metformin-associated lactic acidosis: reinforcing learning points.BMJ case reports · 2020Article
- Association between metformin use prior to admission and lower mortality in septic adult patients with diabetes mellitus: beware of potential confounders.Critical care (London, England) · 2020Article
- A patient with metformin-associated lactic acidosis successfully treated with continuous renal replacement therapy: a case report.Journal of medical case reports · 2019Article
- Metformin Intoxication with Severe Renal Damage: An Adolescent Case Report.Journal of pediatric intensive care · 2019Article
- A 35-Year-Old Woman With Shock, Pulseless Electrical Activity Arrest, and Hemodynamic Collapse.Chest · 2019Article
- Metformin-associated lactic acidosis treated successfully by peritoneal dialysis in a resource limited setting: case report.The Pan African medical journal · 2019Article
- Metformin-associated lactic acidosis precipitated by liraglutide use: adverse effects of aggressive antihyperglycaemic therapy.BMJ case reports · 2018Article
- Risk of lactic acidosis in type 2 diabetes patients using metformin: A case control study.PloS one · 2018Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMetformin-associated lactic acidosis (MALA) is a severe metabolic failure with high related mortality. Although its use is controversial, intermittent hemodialysis is reported to be the most frequently used treatment in conjunction with nonspecific supportive measures. Our aim was to report the evolution and outcome of cases managed by continuous renal replacement therapy (CRRT). METHODOLOGY AND PRINCIPAL
findingsOver a 3-year period, we retrospectively identified patients admitted to the intensive care unit for severe lactic acidosis caused by metformin. We included patients in our study who were treated with CRRT because of shock. We describe their clinical and biological features at admission and during renal support, as well as their evolution. We enrolled six patients with severe lactic acidosis; the mean pH and mean lactate was 6.92±0.20 and 14.4±5.1 mmol/l, respectively. Patients had high illness severity scores, including the Simplified Acute Physiology Score II (SAPS II) (average score 63±12 points). Early CRRT comprised either venovenous hemofiltration (n = 3) or hemodiafiltration (n = 3) with a mean effluent flow rate of 34±6 ml/kg/h. Metabolic acidosis control and metformin elimination was rapid and there was no rebound. Outcome was favorable in all cases. CONCLUSIONS AND SIGNIFICANCE: Standard use of CRRT efficiently treated MALA in association with symptomatic organ supportive therapies.
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