A case of metformin-associated encephalopathy in a patient undergoing maintenance hemodialysis - PubMed
5 hours ago
- #lactic acidosis
- #hemodialysis
- #metformin-associated encephalopathy
- Metformin use in dialysis patients is not recommended due to risk of lactic acidosis, with few reported cases of metformin-associated lactic acidosis (MALA) or encephalopathy.
- A 67-year-old man on maintenance hemodialysis presented with impaired consciousness, severe hypoglycemia (blood glucose 18 mg/dL), metabolic acidosis, and lactic acidosis (pH 6.989, lactate 10.7 mmol/L), leading to a diagnosis of MALA.
- Emergency hemodialysis and glucose correction were initiated; MRI showed symmetrical swelling in bilateral basal ganglia, confirming metformin-associated encephalopathy.
- The patient's condition improved with frequent dialysis sessions, with subsequent MRI showing lesion improvement, and he was discharged after 17 days.
- This case reinforces that metformin should not be prescribed to dialysis patients to prevent such complications.