Metformin: Associated lactic acidosis

In this paper, we provide a brief review of metformin-associated lactic acidosis in renal patients with stage 3 to 4 chronic kidney disease. A 70-year-old male patient is presented, who has been treated for type 2 diabetes for the past twenty years. Since he was taking high doses of metformin at home, without the supervision of his family or doctor, he was urgently admitted to the Nephrology Clinic of the Clinical Center of Montenegro in Podgorica, where diagnostics were immediately performed and the patient was included in hemodialysis, along with other symptomatic and conservative therapy. During hospitalization, the patient's general condition and laboratory analyses of nitrogenous substances and potassium improved. In our case, the patient's treatment with hemodialysis led to rapid correction of metabolic disorders and hemodynamic stabilization, and ultimately to recovery, so there was no need for his further hemodialysis treatment. The patient was discharged home in good general condition, and it can be concluded that timely diagnosis of metformin-associated lactic acidosis is of great importance for hemodialysis treatment, which successfully corrects a severe metabolic disorder. This case suggests the importance of early recognition and treatment of patients with lactic acidosis in diabetics and renal patients who are taking uncontrolled or inadequate metformin therapy for the treatment of type 2 diabetes.