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Metformin Kullanırken Diyare ve Akut Böbrek Yetmezliği Gelişen Hastada, Metformine Bağlı Laktik Asidoz: Olgu Sunumu

Lactic Acidosis Secondary to Metformin in a Patient Presenting with Acute Renal Failure due to Diarrhea: Case Report

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2013
DOI: 
DOI 10.5262/tndt.2013.1001.24

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Metformin is a biguanide used in the treatment of type 2 diabetic patients with normal renal function. Lactic acidosis is the most serious side effect of metformin. Renal failure is the most common cause of reduced lactate excretion. It is aimed to present a case of metformin-induced lactic acidosis exacerbated by acute renal failure. A 68-year-old female patient used metformin was admitted to the infectious disease department due to diarrhea, nausea and vomiting. Type B lactic acidosis due to metformin was diagnosed after the detection of high anion gap metabolic acidosis and high lactate level on blood gas analysis. Hemodialysis was performed because of acute renal failure. The patient was discharged on the 11th day of the hospitalization with normal serum parameters. Metformin may cause lactic acidosis among patients with acute renal failure; early hemodialysis provides rapid clinical improvement.
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Abstract (Original Language): 
Metformin biguanid sınıfından, Tip 2 diyabetiklerde, özellikle böbrek fonksiyonları normal hastalarda ilk basamakta kullanılan oral antidiyabetiktir. Metforminin en ciddi yan etkisi laktik asidozdur. Böbrek yetersizliği laktat atılım bozukluğunun en sık sebebidir. Metformin kullanan bir hastada gelişen akut böbrek yetersizliğinin alevlendirdiği laktik asidoz tablosunun sunulması amaçlanmıştır. Atmış sekiz yaşında bayan hasta metformin kullanırken iki haftadır devam eden ishal, bulantı ve kusma yakınmaları ile enfeksiyon hastalıkları servisine yatırıldı. Kan gazında artmış anyon açıklı metabolik asidoz saptandı. Laktik asit düzeyi yüksek saptanması üzerine metformin kullanımına bağlı Tip B laktik asidoz olarak değerlendirildi. Hasta akut böbrek yetmezliği nedeni ile hemodiyalize alındı. Yatışının 11. gününde tüm kan parametreleri düzelmiş olarak şifa ile taburcu edildi. Metformin böbrek yetersizliği gelişen hastalarda laktik asidoza sebep olabilmektedir, bu hastalarda erken diyaliz klinik durumun hızla düzelmesini sağlar.
FULL TEXT (PDF): 
PDF icon arastrmx_172977_22_pp_133-135.pdf
  • 1
133-135
  • Turkish

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