Metformin-Associated Acute Kidney Injury and Lactic Acidosis
Table 1
Clinical and analytical characteristics of the patients.
Patients classified according to renal function
All patients n = 29
eGFR > 60 mL/min* n = 12
eGFR < 60 mL/min* n = 17
†
Age Gender (M/F) (%)
72 ± 8.78 44.8/55.2
70.33 ± 5.74 50/50
73.18 ± 10.42 41.2/58.8
0.40 0.64
Coexisting conditions (%):
(i) Hypertension
100
100
100
—
(ii) Chronic heart disease
38
25
53
0.13
(iii) Cerebrovascular disease
31
25
35
0.56
(iv) Cancer
24
33
18
0.33
(v) Liver disease
10
8
12
0.77
(vi) Peripheral vasculopathy
10
0
18
0.12
(vii) Chronic respiratory disease
3
8
0
0.23
Other treatments (%): Antihypertensive drugs: ‡
(i) RAAS blockers
86
91.7
82.4
0.47
(a) of which ACE inhibitors
59
(b) of which ARB
24
(c) of which dual block
3
(ii) Diuretics
55
50
58.8
0.64
Other antidiabetic agents:
(i) Other oral antidiabetic drugs
41
33.3
47.1
0.46
(ii) Insulin
21
33.3
17.6
0.33
Laboratory values at diagnosis:
(i) Creatinine (μmol/L)
599.35 ± 299.68
675.38 ± 302.33
544.55 ± 295.26
0.25
(ii) eGFR (mL/min/1.73 m2)
10.47 ± 7.94
8.73 ± 6.98
11.69 ± 8.55
0.33
(iii) Urea (mmol/L)
58.01 ± 20.75
58.52 ± 24.73
57.65 ± 18.23
0.91
(iv) pH
7.12 ± 0.19
7.12 ± 0.18
7.12 ± 0.20
0.96
(v) Lactate (mmol/L)
9.05 ± 4.99
8.92 ± 5.02
9.07 ± 5.16
0.94
(vi) Bicarbonate (mmol/L)
11.14 ± 7.23
10.84 ± 7.51
11.35 ± 7.25
0.86
(vii) Anion gap
29.03 ± 10.23
28.58 ± 12.51
28.94 ± 9.62
0.93
(viii) Sodium (mmol/L)
134.17 ± 7.09
135.42 ± 5.25
133.29 ± 8.20
0.44
(ix) Chloride (mmol/L)
94.24 ± 8.64
96 ± 7.82
93 ± 9.20
0.37
(x) Potassium (mmol/L)
5.65 ± 1.36
6.01 ± 1.09
5.40 ± 1.50
0.24
(xi) Phosphate (mmol/L)
2.48 ± 1.40
2.63 ± 1.89
2.37 ± 0.92
0.63
(xii) Hemoglobin (g/L)
117.7 ± 22.4
111.4 ± 17.1
122.1 ± 25.0
0.21
(xiii) Total serum proteins (g/L)
66.9 ± 12.4
68.3 ± 10.9
66.0 ± 13.5
0.64
(xiv) Albumin (g/L)
32.8 ± 5.1
32.9 ± 5.3
32.8 ± 5.2
0.96
Blood pressure at diagnosis (mm Hg):
(i) Systolic
119.31 ± 37.31
121.33 ± 42.84
117.88 ± 34.20
0.81
(ii) Diastolic
63.00 ± 19.50
62.09 ± 21.17
63.59 ± 18.98
0.85
(iii) Mean
81.41 ± 24.41
80.97 ± 28.44
81.69 ± 22.36
0.94
Endpoints:
(i) RRT requirement (%)
30
91.7
47.1
0.013
(ii) Creatinine at discharge (μmol/L)
138.79 ± 42.43
123.76 ± 28.29
150.28 ± 48.62
0.09
(iii) eGFR at discharge (mL/min/1.73 m2)*
42.72 ± 12.60
46.50 ± 13.03
39.95 ± 11.95
0.20
(iv) Creatinine 3 months after discharge (μmol/L)
106.96 ± 38.01
99.01 ± 32.71
111.38 ± 40.66
0.47
(v) eGFR 3 months after discharge (mL/min/1.732)*
63.82 ± 28.60
65.59 ± 22.43
62.73 ± 32.65
0.83
Mean ± standard deviation for quantitative variables; percentages for qualitative variables.*Estimated glomerular filtration rate (eGFR) calculated according to the MDRD-4-IMDS equation.†Significant values between groups highlighted in bold.‡RAAS: renin-angiotensin-aldosterone system; ACE: angiotensin-converting enzyme; ARB: aldosterone-receptor blockers.
