Case of lactacidosis in acute kidney damage and metformin therapy

Тhe article provides a clinical observation of the development of a rare pathological condition of lactic acidosis in a patient with acute kidney injury while taking metformin and confirms the need for timely determination of blood lactate.

Тhe clinical case confirms that the development of lactic acidosis in a patient with diabetes mellitus may have a mixed etiology and be associated not only with the use of metformin, but also with the presence of tissue hypoxia, exposure to an infectious process, and impaired renal function.

The development of lactic acidosis is associated with an increase in secretion and / or a decrease in the rate of excretion of lactate, which is expressed in a state of metabolic acidosis and severe cardiovascular insufficiency. The development of lactic acidosis is most often associated with the presence of renal and / or hepatic insufficiency, diabetes mellitus, lung pathology, macromicrocirculation disorders, and hemoglobin function defects, the treatment with biguanide drugs (metformin). Diagnosis of lactic acidosis is based on the data from a biochemical blood test and electrolyte parameters – the concentration of blood plasma lactate, the study of acid-base state of the blood and anion gap.