Metformin associated with Renal Failure and Lactic Acidosis

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Metformin associated with Renal Failure and Lactic Acidosis

JoAnn Guest

Jul 02, 2006 18:24 PDT

 

Renal Failure & Lactic Acidosis in

Diabetic Woman Receiving *Metformin*(a Diabetic Drug)

,Rofecoxib

 

Acute Renal Failure and Lactic Acidosis Reported in Diabetic Woman

Receiving Metformin and Rofecoxib-British Journal of Anaesthesia

12/09/2003 By Keely S. Solomon, PhD

 

Doctors report that rofecoxib, a COX 2 inhibitor, may have

contributed to a case of acute renal failure and metformin-related

lactic acidosis.

 

COX 2 inhibitors are becoming increasingly popular for treatment of

inflammatory conditions due to a reduced incidence of

gastrointestinal side effects compared with traditional non-

steroidal

anti-inflammatory drugs (NSAIDS).

 

" What is less well appreciated is the role that the COX 2 inhibitors

may play in the development of renal failure, " writes Grant Price,

of

Victoria Hospital, Kirkcaldy, Fife, Scotland.

 

In the case report, Dr. Price describes a 58-year-old woman

diagnosed

with acute renal failure and lactic acidosis. The patient had a

medical history that included 10 years of type 2 diabetes mellitus

treated with diet modification and metformin.

 

According to Dr. Price, metformin therapy leads to an increase in

lactic acid production, and type B lactic acidosis has been

documented as a rare complication of this treatment. Moreover, any

renal impairment results in a reduced clearance of lactic acid,

which

can increase the risk for lactic acidosis in patients receiving

metformin.

 

" The COX 2 inhibitors may have an improved side-effect profile with

regard to gastric side effects, but their renal safety profile has

not been established, " cautions Dr. Price.

 

Based on the evidence from this case, he suggests that COX 2

inhibitors " can lead to a potentially disastrous outcome " in

patients receiving metformin.

Br J Anaesth 2003 Dec;91:6:909-10.

 

http://www.docguide.com/news/content.nsf/news/

645F9985BE5980A485256DF700508846

 

 

JoAnn Guest

mrsjo-

www.geocities.com/mrsjoguest/Diets