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Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2025, vol. 31, issue3
Subject Area: Medicine
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DOI: 10.5272/jimab.2025313.6366
Published online: 05 August 2025
Case reports
J of IMAB. 2025 Jul-Sep;31(3):6366-6370
ACUTE KIDNEY INJURY DUE TO METFORMIN-ASSOCIATED LACTIC ACIDOSIS
Svilena Aleksandrova
, Stela Linkova, Yulia Benovska, Biser Borisov,
Department of Nephrology, Faculty of Medicine, Medical University, Pleven, Bulgaria.
ABSTRACT:
Introduction: Acute kidney injury is a clinical syndrome of rapid decline of renal function due to various causes and often occurs by more than one pathophysiological mechanism. It is associated with multiorgan involvement and correlates with high mortality, especially when it develops in already hospitalized patients. Metformin-associated lactic acidosis is a special case of lactic acidosis associated with the intake of antidiabetic drugs from the biguanide group in patients with diabetes mellitus type 2. Mortality in severe forms can exceed 50%.
Case description: We present two clinical cases of severe acute kidney injury due to metformin-dependent lactic acidosis requiring temporary use of renal replacement therapy, and offer a brief overview of the specific changes in metformin lactic acidosis, as well as our perspective on the behavior.
Conclusion: In our opinion, the use of metformin in patients with type 2 diabetes mellitus should be strictly controlled, and if it is not possible - should be avoided. We assume that the number of patients with metformin lactic acidosis and the mortality rate are lower than the real ones due to omissions or late diagnosis.
Keywords: diabetes mellitus type 2, metformin, lactic acidosis, acute kidney injury, hemodialysis treatment,
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Please cite this article as: Aleksandrova S, Linkova S, Benovska Y, Borisov B. Acute kidney injury due to metformin-associated lactic acidosis. J of IMAB. 2025 Jul-Sep;31(3):6366-6370. [Crossref - 10.5272/jimab.2025313.6366]
Correspondence to: Svilena Aleksandrova, MD, Department of Nephrology, UMHAT “Dr. G. Stranski” Faculty of Medicine, Medical University, Pleven; 8 A, George Kochev Str., 5800 Pleven, Bulgaria; E-mail: svilena.aleksandrova98@gmail.com
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Received: 04 February 2025
Published online: 05 August 2025