The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Metformin-Induced Lactic Acidosis with Acute Kidney Injury Misdiagnosed as Hepatorenal Syndrome in a Cirrhosis Patient

간신증후군으로 오인하였던 메포르민에 의한 유산산증 1예

  • Kim, Ok-Ki (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Oak, Chan-Young (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Jeong, Ji-Min (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Lee, Jeong-Won (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Shin, Min-Ho (Department of Internal Medicine, Il-Gok Hospital) ;
  • Kim, Nam-Ho (Department of Internal Medicine, Chonnam National University Medical School)
  • 김옥기 (전남대학교 의과대학 내과학교실) ;
  • 옥찬영 (전남대학교 의과대학 내과학교실) ;
  • 정지민 (전남대학교 의과대학 내과학교실) ;
  • 이정원 (전남대학교 의과대학 내과학교실) ;
  • 신민호 (일곡병원 내과) ;
  • 김남호 (전남대학교 의과대학 내과학교실)
  • Published : 2012.02.01
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Abstract

Metformin is a well-established drug for the treatment of type 2 diabetes mellitus. The incidence of metformin-induced lactic acidosis is low, but the estimated mortality rate is approximately 50% in cases with lactic acidosis in combination with metformin therapy. Lactic acidosis occurs most often in patients with compromised cardiac, pulmonary, hepatic, and/or renal function. Acute kidney injury is a relatively frequent problem in cirrhosis patients. Hepatorenal syndrome is a diagnosis of exclusion, making its diagnosis difficult in the clinical field. We report a case of metformin-induced lactic acidosis with acute kidney injury that was misdiagnosed as hepatorenal syndrome in a cirrhosis patient.

저자들은 간경화 환자에서 메포르민에 의해 발생한 유산산증 및 급성 신손상 환자를 약물 복용력이 확인되지 않아 간신증후군으로 오진하였던 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Kang BI, Kim SJ, Kim JH, et al. Two cases of metformin-induced lactic acidosis successfully treated by hemodialysis. Korean J Med 2011;80:473-476.
  2. Herrington WG, Levy JB. Metformin: effective and safe in renal disease? Int Urol Nephrol 2008;40:411-417. https://doi.org/10.1007/s11255-008-9371-6
  3. Choi HS, Jung KH, Shim JJ, et al. A case of metforminassociated lactic acidosis. Korean J Nephrol 2004;23:143-146.
  4. Garcia-Tsao G, Parikh CR, Viola A. Acute kidney injury in cirrhosis. Hepatology 2008;48:2064-2077. https://doi.org/10.1002/hep.22605
  5. Suh YS. Extrahepatic Disorder in Portal Hypertension : Kidney: Hepatorenal syndrome type 1 and 2. Korean J Hepatol 2009;15:69-83.
  6. Forsythe SM, Schmidt GA. Sodium bicarbonate for the treatment of lactic acidosis. Chest 2000;117:260-267. https://doi.org/10.1378/chest.117.1.260
  7. Bruijstens LA, van Luin M, Buscher-Jungerhans PM, Bosch FH. Reality of severe metformin-induced lactic acidosis in the absence of chronic renal impairment. Neth J Med 2008;66:185-190.
  8. Kwak JH, Sung JH, Jin KB, et al. Successful treatment of severe lactic acidosis by continuous venovenous hemodiafiltration. Korean J Nephrol 2006;25:661-667.
  9. Peters N, Jay N, Barraud D, et al. Metformin-associated lactic acidosis in an intensive care unit. Crit Care 2008;12:R149. https://doi.org/10.1186/cc7137
  10. Calabrese AT, Coley KC, DaPos SV, Swanson D, Rao RH. Evaluation of prescribing practices: risk of lactic acidosis with metformin therapy. Arch Intern Med 2002;162: 434-437. https://doi.org/10.1001/archinte.162.4.434

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