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International Journal of Nephrology
Volume 2011 (2011), Article ID 749653, 5 pages
http://dx.doi.org/10.4061/2011/749653
Clinical Study

Metformin-Associated Acute Kidney Injury and Lactic Acidosis

Nephrology Department, Hospital General Universitario Gregorio Marañón, Street Dr. Esquerdo 46, 28007 Madrid, Spain

Received 17 May 2011; Accepted 8 June 2011

Academic Editor: Alejandro Martín-Malo

Copyright © 2011 David Arroyo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. Metformin is the preferred oral antidiabetic agent for type 2 diabetes. Lactic acidosis is described as a rare complication, usually during an acute kidney injury (AKI). Material and Methods. We conducted a prospective observational study of metformin-associated AKI cases during four years. 29 cases were identified. Previous renal function, clinical data, and outcomes were recorded. Results. An episode of acute gastroenteritis precipitated the event in 26 cases. Three developed a septic shock. Three patients died, the only related factor being liver dysfunction. More severe metabolic acidosis hyperkalemia and anemia were associated with higher probabilities of RRT requirement. We could not find any relationship between previous renal dysfunction and the outcome of the AKI. Conclusions. AKI associated to an episode of volume depletion due to gastrointestinal losses is a serious complication in type 2 diabetic patients on metformin. Previous renal dysfunction (mild-to-moderate CKD) has no influence on the severity or outcome.