2023 Volume 36 Issue 1 Pages 27-31
Metformin-associated lactic acidosis is a life-threatening condition characterized by an elevation in serum lactate level in patients with metformin exposure. Here we report a case of lactic acidosis due to metformin overdose, who underwent early introduction of intermittent hemodialysis and successful clinical improvement. An adult patient who had treated diabetes was transferred to our emergency center because of metformin overdose 8 hours before. The patient took a total 54.5 g of metformin and 7.5 mg of repaglinide, and lactic acidosis (pH of 7.299 and lactate levels of 10.4 mmol/L) was determined on hospital arrival. Renal dysfunction and hyperkalemia were also determined and we diagnosed the patient as lactic acidosis caused by metformin overuse. After hospital admission, lactate was continuously increased and we decided to introduce intermittent dialysis 6 hours later on admission because we concerned the exacerbation of lactic acidosis caused by metformin overuse. Successful clinical improvement of the patient was observed because of two times of intermittent dialysis. We concluded that early introduction of intermittent dialysis should be considered as one of the treatment options of lactic acidosis caused by metformin overuse.
