Retrospective analysis of lactic acidosis-related parameters upon and after metformin discontinuation in patients with diabetes and chronic kidney disease
| Autor: | Ali Tamer, Mehmet Yildirim, Ahmed Bilal Genc, Ülkü Yılmaz, Ahmet Nalbant, Seyyid Bilal Acikgoz, Yalcin Solak, Savas Sipahi |
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| Přispěvatelé: | Sipahi, S, Solak, Y, Acikgoz, SB, Genc, AB, Yildirim, M, Yilmaz, U, Nalbant, A, Tamer, A, Sakarya Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Bölümü, Sipahi, Savaş, Yıldırım, Mehmet, Nalbant, Ahmet, Tamer, Ali |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty endocrine system diseases Urology Renal function 030209 endocrinology & metabolism Comorbidity Type 2 diabetes Risk Assessment Severity of Illness Index Gastroenterology Statistics Nonparametric Cohort Studies 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Internal medicine Humans Hypoglycemic Agents Medicine Renal Insufficiency 030212 general & internal medicine Renal Insufficiency Chronic Aged Retrospective Studies business.industry nutritional and metabolic diseases Metabolic acidosis Middle Aged Urology & Nephrology medicine.disease Metformin Discontinuation Endocrinology Diabetes Mellitus Type 2 Withholding Treatment Nephrology Creatinine Lactic acidosis Linear Models Acidosis Lactic Female Hyperlactatemia business Follow-Up Studies Glomerular Filtration Rate medicine.drug |
| Popis: | To investigate association between renal functions, lactic acid levels and acid–base balance in type 2 diabetes patients with chronic kidney disease under metformin treatment and after metformin discontinuation in a real-life setting. A total of 65 patients with diabetes (mean age 68.5 ± 8.9 years, 56.9 % females) in whom metformin treatment was discontinued due to reduced glomerular filtration rate (GFR) were included in this retrospective study. Data on patient demographics, metformin treatment and laboratory findings on the last day of metformin treatment and 2–3 weeks after metformin discontinuation including blood lactate and creatinine, estimated glomerular filtration rate (eGFR) and acid–base balance measurements in blood [pH, bicarbonate, base excess] were collected from medical records. The correlation of lactate levels with eGFR, blood pH and creatinine levels and changes in laboratory findings after metformin discontinuation were evaluated. Before metformin discontinuation, hyperlactatemia was observed in 78.5 % of patients and metabolic acidosis in 36.9 % of patients, but none had lactic acidosis. Patients with normolactatemia and hyperlactatemia were similar in terms of metformin dosage and laboratory parameters. Lactate levels were not significantly correlated with serum creatinine (r = −0.14; p = 0.263) and eGFR (r = 0.11, p = 0.374). After metformin discontinuation, a significant decrease was observed in median lactate levels (from 2.20 to 1.85 mmol/L; p = 0.002). In conclusion, our findings support the low risk of MALA among patients with mild-to-moderate renal impairment and the likelihood of metformin to be an innocent bystander without a pathogenic role in the lactic acidosis in most cases. |
| Databáze: | OpenAIRE |
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