Abstract
Metformin associated lactic acidosis is a severe and potentially fatal condition. We here report a severe metformin-associated lactic acidosis in acute kidney injury caused by bilateral obstructing ureteral stones as an extremely rare combination of pathologies. Early treatment with bicarbonate infusion and subsequent acute haemodialysis. As a result, respiratory failure and mechanical ventilation was prevented and the patient was discharged several days after the event. The patient gave written consent for publication of this case report.
Highlights
Metformin associated lactic acidosis is a severe and potentially fatal condition
The patient responded well to the initial treatment causing a decrease of the respiratory rate. He was subsequently admitted to the ICU for placement of a dialysis catheter and start of urgent haemodialysis
Post renal acute kidney injury develops almost exclusively in ureter obstruction with a single functioning kidney or in bilateral renal or lower urinary tract obstruction, which mostly occurs by prostatic disease in men [2]
Summary
Metformin associated lactic acidosis is a severe and potentially fatal condition. We here report a severe metformin-associated lactic acidosis in acute kidney injury caused by bilateral obstructing ureteral stones as an extremely rare combination of pathologies. Treatment with bicarbonate infusion and subsequent acute haemodialysis was provided. Respiratory failure and mechanical ventilation was prevented and the patient was discharged several days after the event. The patient gave written consent for publication of this case report
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