SynthesisBMC nephrology2017
Serum lactate level and mortality in metformin-associated lactic acidosis requiring renal replacement therapy: a systematic review of case reports and case series.
Synthesis in BMC nephrology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Metformin's Role in Hyperlactatemia and Lactic Acidosis in ICU Patients: A Systematic Review.Pharmacology · 2023Pooled it
- Co-prescription of metformin and glucagon-like peptide-1 receptor agonists and metformin-associated lactic acidosis: A case series.Clinical nephrology. Case studies · 2026Article
- Kidney replacement therapy and mortality in metformin-associated lactic acidosis with acute kidney injury (2015-2021): a multi-year cohort study.Renal failure · 2025Article
- Metformin-Induced Lactic Acidosis Following Intentional Overdose: A Case Report and Mini Review.Cureus · 2025Article
- Non-insulin diabetes medicines: a narrative review for anaesthetists and intensivists.British journal of anaesthesia · 2025Review
- Regional citrate anticoagulation ensures safe and effective kidney replacement therapy in metformin-associated lactic acidosis.Clinical kidney journal · 2025Article
- Article
- Transient Blindness in Metformin-associated Lactic Acidosis: Resolution With Supportive Care.JCEM case reports · 2025Article
- Metformin-associated lactic acidosis: A mini review of pathophysiology, diagnosis and management in critically ill patients.World journal of diabetes · 2024Review
- Reversible acute blindness in suspected metformin-associated lactic acidosis: a case report.Journal of medical case reports · 2023Article
- Cardiac Dysfunction Due to Thiamine Deficiency after Hemodialysis for Biguanide-related Lactic Acidosis.Internal medicine (Tokyo, Japan) · 2022Article
- Metformin toxicity: A meta-summary of case reports.World journal of diabetes · 2022Article
- Metformin-associated lactic acidosis exacerbated by acute kidney injury in an overseas traveler.CEN case reports · 2022Article
- Transient Complete Blindness Due to Metformin-Associated Lactic Acidosis (MALA) Reversed with Hemodialysis.The American journal of case reports · 2022Article
- Metformin-associated lactic acidosis and factors associated with 30-day mortality.PloS one · 2022 · on this mapObservational
- Quality and Characteristics of 4241 Case Reports of Lactic Acidosis in Metformin Users Reported to a Large Pharmacovigilance Database.Therapeutics and clinical risk management · 2022Article
- Reversible Total Vision Loss Caused by Severe Metformin-associated Lactic Acidosis: A Case Report.Clinical practice and cases in emergency medicine · 2021Article
- Risk Factors for the Incidence and Severity of Acute Kidney Injury After Liver Transplantation.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2021Article
- Profound Metabolic Acidosis due to Metformin Intoxication Requiring Dialysis.Case reports in nephrology · 2021Article
- Metformin use and early lactate levels in critically ill patients according to chronic and acute renal impairment.Critical care (London, England) · 2020Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe current practice concerning timing, mode, and dose of renal replacement therapy (RRT) in patients with metformin-associated lactic acidosis (MALA) with renal failure remains unknown. To investigate whether serum lactate level and prescription pattern of RRT are associated with mortality in patients with MALA requiring RRT.
methodsWe searched PubMed/Medline and EMBASE from inception to Sep 2014 and applied predetermined exclusion criteria. Case-level data including case's demographics and clinical information related to MALA were abstracted. Multiple logistic regression modeling was used to examine the predictors of mortality.
resultsA total of 253 unique cases were identified with cumulative mortality of 17.2%. Eighty-seven percent of patients had acute kidney injury. Serum lactate level was significantly higher in non-survivors (median 22.5 mmol/L) than in survivors (17.0 mmol/L, p-value <0.01) and so did the median blood metformin concentrations (58.5 vs. 43.9 mg/L, p-value = 0.05). The survival advantage was not significantly different between the modalities of RRT. The adjusted odds ratio of mortality for every one mmol/L increase in serum lactate level was 1.09 (95% CI 1.02-1.17, p-value = 0.01). The dose-response curve indicated a lactate threshold greater than 20 mmol/L was significantly associated with mortality.
conclusionsOur study suggests that predialysis level of serum lactate level is an important marker of mortality in MALA patients requiring RRT with a linear dose-response relationship. To better evaluate the optimal prescription of RRT in MALA, we recommend fostering an international consortium to support prospective research and large-scale standardized case collection.
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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.