Evidence mapPaperPMID 27102431Full record

ArticleInternational urology and nephrology2016

Retrospective analysis of lactic acidosis-related parameters upon and after metformin discontinuation in patients with diabetes and chronic kidney disease.

Savas Sipahi, Yalcin Solak, Seyyid Bilal Acikgoz, Ahmed Bilal Genc, Mehmet Yildirim, Ulku Yilmaz, Ahmet Nalbant, Ali Tamer

Abstract readComparative Study
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In one paragraph

Article in International urology and nephrology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Savas SipahiDivision of Nephrology, Department of Internal Medicine, Sakarya University Faculty of Medicine, Adnan Menderes Cd. Saglik Sok. No: 195, 54100, Adapazari/Sakarya, Turkey. ssipahi@sakarya.edu.tr.
Yalcin SolakDivision of Nephrology, Department of Internal Medicine, Sakarya University Faculty of Medicine, Adnan Menderes Cd. Saglik Sok. No: 195, 54100, Adapazari/Sakarya, Turkey.
Seyyid Bilal AcikgozDepartment of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey.
Ahmed Bilal GencDepartment of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey.
Mehmet YildirimDepartment of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey.
Ulku YilmazDepartment of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey.
Ahmet NalbantDepartment of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey.
Ali TamerDepartment of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey.
Sakarya University · TR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo 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.

methodsA 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.

resultsBefore 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).

conclusionIn 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.

Indexed as

Acidosis, LacticAdultAgedCohort StudiesComorbidityCreatinineDiabetes Mellitus, Type 2FemaleFollow-Up StudiesGlomerular Filtration RateHumansHypoglycemic AgentsLinear ModelsMaleMetforminMiddle AgedCreatinineHypoglycemic AgentsMetforminDiabetes mellitusLactic acidosisMetforminRenal failure

Identifiers

PMID27102431
OpenAlexW2337335099

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.