유산산증 없이 메포르민으로 유발된 급성 신손상 1예 -증례 보고-
A Case of Metformin-Induced Acute Kidney Injury without Lactic Acidosis -A Case Report-
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Metformin is an oral antidiabetic drug in the biguanide class, which is used for type 2 diabetes. The side effects of metformin are mostly limited to digestive tract symptoms, such as diarrhea, flatulence and abdominal discomfort. The most serious potential adverse effect of metformin is lactic acidosis. A 51-year-old man was admitted due to hypoglycemia as a result of an overdose of antidiabetic drugs. He took massive dose of metformin. Conservative treatment failed for metabolic acidosis without lactic acidosis accompanied by acute kidney injury. Hemodialysis was executed to correct the high anion gap metabolic acidosis and acute kidney injury, and the patient recovered fully from metabolic acidosis. This case illustrates that the presence of clinical conditions, such as metformin-induced acute kidney injury and metabolic acidosis, can be developed without lactic acidosis. Prompt recognition of metabolic acidosis and early intervention with hemodialysis can result in a successful clinical outcome.
Abstract
Metformin is an oral antidiabetic drug in the biguanide class, which is used for type 2 diabetes. The side effects of metformin are mostly limited to digestive tract symptoms, such as diarrhea, flatulence and abdominal discomfort. The most serious potential adverse effect of metformin is lactic acidosis. A 51-year-old man was admitted due to hypoglycemia as a result of an overdose of antidiabetic drugs. He took massive dose of metformin. Conservative treatment failed for metabolic acidosis without lactic acidosis accompanied by acute kidney injury. Hemodialysis was executed to correct the high anion gap metabolic acidosis and acute kidney injury, and the patient recovered fully from metabolic acidosis. This case illustrates that the presence of clinical conditions, such as metformin-induced acute kidney injury and metabolic acidosis, can be developed without lactic acidosis. Prompt recognition of metabolic acidosis and early intervention with hemodialysis can result in a successful clinical outcome.
참고문헌 (15)
- 최혜숙, "메포르민사용에 의한 유산산증(Lactic Acidosis) 1예", Kidney Research and Clinical Practice, 23(1), pp.143~146 (2004), 대한신장학회
- Bailey CJ, "Metformin", N Engl J Med, 334, pp.574~579 (1996)
- Kang BS, "A case of severe lactic acidosis induced by metformin overdose", Korean J Med, 75, pp.894~897 (2008)
- 강병일, "혈액투석으로 성공적으로 치료한 메포르민 유산산증 2예", 대한내과학회지, 80(4), pp.473~476 (2011), 대한내과학회
- Alivanis P, "Metformin-associated lactic acidosis treated with con tinuous renal replacement therapy", Clin Ther, 28, pp.396~400 (2006)
- Kirpichnikov D, "Metformin: an update", Ann Intern Med, 137, pp.25~33 (2002)
- Shaw JS, "Establishing pragmatic estimated GFR thresholds to guide metformin prescribing", Diabet Med, 24, pp.1160~1163 (2007)
- Pompermayer K, "The ATP-sensitive potassium channel blocker glibenclamide prevents renal ischemia", reperfusion injury in rats, 2005, pp.67, 1785~1796
- Burton David Rose, "Clinical Physiology of Acid-Base and Electrolyte Disorders. 3rd ed", pp.506~512 (1989), McGrow- Hill
- Jang JE, "The impacts of alcohol consumption on glucose metabolism", J Korean Diabetes, 13, pp.81~84 (2012)
- Morris CG, "Metabolic acidosis in the critically ill: part 2. Causes and treatment", Anaesthesia, 63, pp.396~411 (2008)
- Thadhani R, "Acute renal failure", N Engl J Med, 334, pp.1448~1460 (1996)
- 이경민, "Influence of Blood Glucose Level on Acid-Base Balance", 대한중환자의학회지, 24(1), pp.17~21 (2009), 대한중환자의학회
- Bong JD, "Outcome of Early Diagnos is and Hemodialys is in Acute Renal Failure due to Metformin-associated Lactic Acidosis in Elderly Type 2 Diabetes Mellitus Patient", J Korean Geriatr Soc, 8, pp.115~118 (2004)
- Heaney D, "Bicarbonate haemodialysis as a treatment of metformin overdose", Nephrol Dial Transplant, 12, pp.1046~1047 (1997)