Metformin-Associated Lactic Acidosis (MALA). Our experiencie and a review
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| Format: | Artículo científico |
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Hospital San Pedro
2025
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| author | Enrique Chicote-Álvarez |
| author_facet | Enrique Chicote-Álvarez |
| contents | Metformin-Associated Lactic Acidosis (MALA). Our experiencie and a review Enrique Chicote-Álvarez Helena Camino-Ferró Marlene Feo-González Maite Arlabán-Carpintero Natalia Gloria Lizama-Gómez Medicina Metformin Critical care Lactic acidosis Introduction: Metformin (a biguanide) for the treatment of Type 2 Diabetes Mellitus is widely used worldwide. However, is a double-edged sword for critically ill patients. One of the most important problems with its use is the risk of developing metformin-associated lactic acidosis (MALA). We present our 10-year experience with lactic acidosis attributed to MALA as well as a review of the literature. Material and methods: We reviewed admissions to the Intensive Care Unit (ICU) of a secondary-level hospital (630 inpatient beds) with diagnoses of "metabolic acidosis," "lactic acidosis," and "metformin-associated lactic acidosis" from January 2014 to June 2024. Data were collected from patients' electronic medical records and entered into an Excel® document for analysis. Results: Of the total 72 cases reviewed, 11 were included. Nine cases were male (81.82%), with a mean age of 75.36 years (ages ranging from 63 to 80 years). None of the cases had a history of chronic kidney disease, but all presented with acute renal failure. Renal replacement therapies (RRT) were used in all cases, with 6 patients initially treated with and 9 patients with conventional hemodialysis. The mortality rate was 0%. However, in the literature MALA presents a mortality exceeding 10% according to several studies. Conclusions: MALA is a very serious condition and early diagnosis is very important. The use of renal replacement therapies is of Paramount importance as well as clinical suspicion. 2025 artículo científico 2695-5075 https://www.redalyc.org/articulo.oa?id=692082831003 https://www.redalyc.org/journal/6920/692082831003/ https://www.redalyc.org/journal/6920/692082831003/html/ https://www.redalyc.org/journal/6920/692082831003/692082831003.epub https://www.redalyc.org/journal/6920/692082831003/movil 10.53986/ibjm.2025.0007 en http://www.redalyc.org/revista.oa?id=6920 Iberoamerican Journal of Medicine application/pdf Hospital San Pedro Iberoamerican Journal of Medicine (España) Num.2 Vol.7 |
| format | Artículo científico |
| id | redalyc_692082831003 |
| institution | Redalyc |
| language | en |
| publishDate | 2025 |
| publisher | Hospital San Pedro |
| spellingShingle | Metformin-Associated Lactic Acidosis (MALA). Our experiencie and a review Enrique Chicote-Álvarez Medicina Metformin Critical care Lactic acidosis Metformin-Associated Lactic Acidosis (MALA). Our experiencie and a review Enrique Chicote-Álvarez Helena Camino-Ferró Marlene Feo-González Maite Arlabán-Carpintero Natalia Gloria Lizama-Gómez Medicina Metformin Critical care Lactic acidosis Introduction: Metformin (a biguanide) for the treatment of Type 2 Diabetes Mellitus is widely used worldwide. However, is a double-edged sword for critically ill patients. One of the most important problems with its use is the risk of developing metformin-associated lactic acidosis (MALA). We present our 10-year experience with lactic acidosis attributed to MALA as well as a review of the literature. Material and methods: We reviewed admissions to the Intensive Care Unit (ICU) of a secondary-level hospital (630 inpatient beds) with diagnoses of "metabolic acidosis," "lactic acidosis," and "metformin-associated lactic acidosis" from January 2014 to June 2024. Data were collected from patients' electronic medical records and entered into an Excel® document for analysis. Results: Of the total 72 cases reviewed, 11 were included. Nine cases were male (81.82%), with a mean age of 75.36 years (ages ranging from 63 to 80 years). None of the cases had a history of chronic kidney disease, but all presented with acute renal failure. Renal replacement therapies (RRT) were used in all cases, with 6 patients initially treated with and 9 patients with conventional hemodialysis. The mortality rate was 0%. However, in the literature MALA presents a mortality exceeding 10% according to several studies. Conclusions: MALA is a very serious condition and early diagnosis is very important. The use of renal replacement therapies is of Paramount importance as well as clinical suspicion. 2025 artículo científico 2695-5075 https://www.redalyc.org/articulo.oa?id=692082831003 https://www.redalyc.org/journal/6920/692082831003/ https://www.redalyc.org/journal/6920/692082831003/html/ https://www.redalyc.org/journal/6920/692082831003/692082831003.epub https://www.redalyc.org/journal/6920/692082831003/movil 10.53986/ibjm.2025.0007 en http://www.redalyc.org/revista.oa?id=6920 Iberoamerican Journal of Medicine application/pdf Hospital San Pedro Iberoamerican Journal of Medicine (España) Num.2 Vol.7 |
| title | Metformin-Associated Lactic Acidosis (MALA). Our experiencie and a review |
| topic | Medicina Metformin Critical care Lactic acidosis |
| url | https://www.redalyc.org/articulo.oa?id=692082831003 https://www.redalyc.org/journal/6920/692082831003/ https://www.redalyc.org/journal/6920/692082831003/html/ https://www.redalyc.org/journal/6920/692082831003/692082831003.epub https://www.redalyc.org/journal/6920/692082831003/movil |