TY - JOUR
T1 - Metformin-Associated Lactic Acidosis Undergoing Renal Replacement Therapy in Intensive Care Units
T2 - A Five-Million Population-Based Study in the North-West of Italy
AU - Mariano, Filippo
AU - Pozzato, Marco
AU - Inguaggiato, Paola
AU - Guarena, Cesare
AU - Turello, Ernesto
AU - Manes, Massimo
AU - David, Paola
AU - Berutti, Silvia
AU - Consiglio, Valentina
AU - Amore, Alessandro
AU - Campo, Andrea
AU - Marino, Angela
AU - Berto, Mauro
AU - Carpani, Paola
AU - Calabrese, Giovanni
AU - Gherzi, Maurizio
AU - Stramignoni, Emanuele
AU - Martina, Guido
AU - Serra, Andrea
AU - Comune, Luciano
AU - Roscini, Elisabetta
AU - Marciello, Antonio
AU - Todini, Vincenzo
AU - Vio, Patrizia
AU - Filiberti, Oliviero
AU - Boero, Roberto
AU - Cantaluppi, Vincenzo
N1 - Publisher Copyright:
© 2017 S. Karger AG, Basel.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Background: Metformin-associated lactic acidosis (MALA) is a severe complication of drug administration with significant morbidity and mortality. So far no study in large population areas have examined the incidence, clinical profile and outcome of acute kidney injury (AKI)-MALA patients admitted in intensive care units (ICUs) and treated by renal replacement therapy (MALA-RRT). Methods: Retrospective analysis over a 6-year period (2010-2015) in Piedmont and Aosta Valley regions (5,305,940 inhabitants, 141,174 diabetics treated with metformin) of all MALA-RRT cases. Results: One hundred and seventeen cases of AKI-MALA-RRT were observed (12.04/100,000 metformin treated diabetics, 1.45% of all RRT-ICU patients). Survival rate was 78.3%. The average duration of RRT was 4.0 days at mean dialysis effluent of 977 mL/kg/day. At admission most patients were dehydrated, and experienced shock and oliguria. Conclusion: Our data showed that MALA-RRT is a common complication, needing more prevention. Adopted policy of early, extended, continuous and high efficiency dialysis could contribute to an observed high survival rate. Video Journal Club "Cappuccino with Claudio Ronco" at http://www.karger.com/?doi=471917.
AB - Background: Metformin-associated lactic acidosis (MALA) is a severe complication of drug administration with significant morbidity and mortality. So far no study in large population areas have examined the incidence, clinical profile and outcome of acute kidney injury (AKI)-MALA patients admitted in intensive care units (ICUs) and treated by renal replacement therapy (MALA-RRT). Methods: Retrospective analysis over a 6-year period (2010-2015) in Piedmont and Aosta Valley regions (5,305,940 inhabitants, 141,174 diabetics treated with metformin) of all MALA-RRT cases. Results: One hundred and seventeen cases of AKI-MALA-RRT were observed (12.04/100,000 metformin treated diabetics, 1.45% of all RRT-ICU patients). Survival rate was 78.3%. The average duration of RRT was 4.0 days at mean dialysis effluent of 977 mL/kg/day. At admission most patients were dehydrated, and experienced shock and oliguria. Conclusion: Our data showed that MALA-RRT is a common complication, needing more prevention. Adopted policy of early, extended, continuous and high efficiency dialysis could contribute to an observed high survival rate. Video Journal Club "Cappuccino with Claudio Ronco" at http://www.karger.com/?doi=471917.
UR - http://www.scopus.com/inward/record.url?scp=85022090093&partnerID=8YFLogxK
U2 - 10.1159/000471917
DO - 10.1159/000471917
M3 - Article
SN - 0253-5068
VL - 44
SP - 198
EP - 205
JO - Blood Purification
JF - Blood Purification
IS - 3
ER -
