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AKI Metformin

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21 papers 0 to 25 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/27908266/is-metformin-a-perfect-drug-updates-in-pharmacokinetics-and-pharmacodynamics
#1
Magdalena Markowicz-Piasecka, Kristiina Maria Huttunen, Łukasz Mateusiak, Elżbieta Mikiciuk-Olasik, Joanna Sikora
Metformin, a synthetic biguanide, is currently one of the most frequently recommended medications for type 2 diabetes treatment around the world. In this review, we present the latest discoveries in the pharmacokinetics of metformin, especially the role of transporters (e.g. Organic Cation Transporters OCTs, Multidrug and Toxin Extrusion transporters MATE) in oral absorption, distribution, elimination and biochemical effects of metformin in humans. We also review the associations between genetic variations of metformin transporters, their pharmacokinetics and drug efficacy or drug responses...
December 1, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27861334/lactic-acidosis-and-the-relationship-with-metformin-usage-case-reports
#2
Weiyi Huang, Ronald L Castelino, Gregory M Peterson
AIMS: The principal objective of this study was to retrospectively review a series of cases of lactic acidosis (LA) in patients with type 2 diabetes mellitus (T2DM) and examine the relationship with the use of metformin. More generally, the study enabled an investigation of the profiles of patients diagnosed with LA and clinical variables associated with in-hospital mortality. METHODS: All patients admitted to the Royal Hobart Hospital in Tasmania with LA (lactate >5...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27805342/management-of-sitagliptin-and-metformin-combination-toxic-overdose
#3
Sudhish Sehra, Shalini Jaggi, Devindra Sehra, Rajesh Aggarwal, Vikas Saraswat, Deven Juneja
Metformin and Sitagliptin are often used in combination in the management of non-insulin dependent diabetes mellitus. Though toxicity is rare, but occurs more frequently in cases of intentional or unintentional overdose of these drugs. Here, we present a case of an intentional overdose of a metformin- sitagliptin combination (70g metformin and 3500mg sitagliptin) in a suicide attempt by a young non-diabetic female who presented with severe lactic acidosis and was successfully treated with prompt hemodialysis and bicarbonate therapy...
November 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27760420/risks-of-metformin-in-type-2-diabetes-and-chronic-kidney-disease-lessons-learned-from-taiwanese-data
#4
Connie M Rhee, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
Like other biguanide agents, metformin is an anti-hyperglycemic agent with lower tendency towards hypoglycemia compared to other anti-diabetic drugs. Given its favorable effects on serum lipids, obese body habitus, cardiovascular disease, and mortality, metformin is recommended as the first-line pharmacologic agent for type 2 diabetes in the absence of contraindications. However, as metformin accumulation may lead to type B non-hypoxemic lactic acidosis, especially in the setting of kidney injury, chronic kidney disease, and overdose, regulatory agencies such as the United States Food and Drug Administration (FDA) have maintained certain restrictions regarding its use in kidney dysfunction...
October 20, 2016: Nephron
https://www.readbyqxmd.com/read/27686366/metformin-related-lactic-acidosis-is-it-a-myth-or-an-underestimated-reality
#5
Luca Visconti, Valeria Cernaro, Domenico Ferrara, Giuseppe Costantino, Carmela Aloisi, Luisa Amico, Valeria Chirico, Domenico Santoro, Alberto Noto, Antonio David, Michele Buemi, Antonio Lacquaniti
Metformin, belonging to a class of drugs called biguanides, is the recommended first-line treatment for overweight patients with type 2 diabetes mellitus. It has multiple mechanisms of action, such as reduction of gluconeogenesis, increases peripheral uptake of glucose, and decreases fatty acid oxidation. However, a potential serious complication, defined metformin-associated lactic acidosis (MALA), is related to increased plasma lactate levels, linked to an elevated plasma metformin concentrations and/or a coexistent condition altering lactate production or clearance...
August 10, 2016: Renal Failure
https://www.readbyqxmd.com/read/27680758/the-phantom-of-metformin-induced-lactic-acidosis-in-end-stage-renal-disease-patients-time-to-reconsider-with-peritoneal-dialysis-treatment
#6
Abdullah K Al-Hwiesh, Ibrahiem S Abdul-Rahman, Abdul-Salam Noor, Mohammed A Nasr-El-Deen, Abdalla Abdelrahman, Tamer S El-Salamony, Fahd A Al-Muhanna, Khalid M Al-Otaibi, Nehad Al-Audah
♦ Objective: Metformin continues to be the safest and most widely used antidiabetic drug. In spite of its well-known benefits; metformin use in end-stage renal disease (ESRD) patients is still restricted. Little has been reported about the effect of peritoneal dialysis (PD) on metformin clearance and the phantom of lactic acidosis deprives ESRD patients from metformin therapeutic advantages. Peritoneal dialysis is probably a safeguard against lactic acidosis, and it is likely that using this drug would be feasible in this group of patients...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27509590/peritoneal-dialysis-treatment-of-metformin-associated-lactic-acidosis-in-a-diabetic-nephropathy-patient%C3%A2
#7
Jianjun Gao, Zhaoyan Gu, Yongxing Xu, Yu Na
We report a case of metformin-associated lactic acidosis (MALA) in a 66-year-old man with end-stage renal disease on peritoneal dialysis (PD). The patient presented with severe lactic acidosis and was treated successfully with automated peritoneal dialysis (APD). During the treatment, PD solution was prepared from hemofiltration substitute fluid. The prescription was 8 cycles of 2,000 mL over 24 hours with the prepared solution, and venoclysis with sodium bicarbonate to improve the acidosis. After 3 days of treatment, his lactic acidosis was corrected...
November 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27627216/nephroprotective-effects-of-metformin-in-diabetic-nephropathy
#8
Sreenithya Ravindran, Vinitha Kuruvilla, Kerry Wilbur, Shankar Munusamy
Metformin, a well-known anti-diabetic agent, is very effective in lowering blood glucose in patients with type 2 diabetes with minimal side-effects. Metformin is also being recommended in the treatment of obesity and polycystic ovary syndrome. Metformin elicits its therapeutic effects mainly via activation of AMP-activated kinase (AMPK) pathway. Renal cells under hyperglycemic or proteinuric conditions exhibit inactivation of cell defense mechanisms such as AMPK and autophagy, and activation of pathologic pathways such as mammalian target of rapamycin (mTOR), endoplasmic reticulum (ER) stress, epithelial-to-mesenchymal transition (EMT), oxidative stress, and hypoxia...
September 14, 2016: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/27504911/metformin-use-and-risk-of-lactic-acidosis-in-people-with-diabetes-with-and-without-renal-impairment-a-cohort-study-in-denmark-and-the-uk
#9
L Li, S Jick, C Gopalakrishnan, U Heide-Jørgensen, H Nørrelund, H T Sørensen, C F Christiansen, V Ehrenstein
AIMS: To assess risk of lactic acidosis among metformin users compared with other glucose-lowering agent users, according to renal function. METHODS: Using routine registries and databases, we conducted a cohort study. Of 43 580 metformin and 37 788 other glucose-lowering agent users in northern Denmark and 102 688 metformin and 28 788 other glucose-lowering agent users in the UK during 2001-2011, we identified lactic acidosis using diagnostic codes. We calculated the incidence rates of lactic acidosis in metformin and other glucose-lowering agent users overall and according to baseline estimated GFR (eGFR) levels...
August 9, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/27534835/metformin-associated-risk-of-acute-dialysis-in-patients-with-type-2-diabetes-a-nationwide-cohort-study
#10
Nicholas Carlson, Kristine Hommel, Jonas B Olesen, Thomas A Gerds, Anne-Merete Soja, Tina Vilsbøll, Anne-Lise Kamper, Christian Torp-Pedersen, Gunnar Gislason
Recent guidelines governing anti-diabetic medications increasingly advocate metformin as first-line therapy in all patients with type 2 diabetes. However, metformin could be associated with increased risk of acute kidney injury (AKI), acute dialysis and lactate acidosis in marginal patients. In a retrospective nationwide cohort study, a total of 168 443 drug-naïve patients with type 2 diabetes ≥50 years, initiating treatment with either metformin or sulphonyl in Denmark between 2000 and 2012 were included in this study (70...
December 2016: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/27413035/antihyperglycemic-medication-use-among-medicare-beneficiaries-with-heart-failure-diabetes-mellitus-and-chronic-kidney-disease
#11
Priyesh A Patel, Li Liang, Prateeti Khazanie, Bradley G Hammill, Gregg C Fonarow, Clyde W Yancy, Deepak L Bhatt, Lesley H Curtis, Adrian F Hernandez
BACKGROUND: Diabetes mellitus, heart failure (HF), and chronic kidney disease are common comorbidities, but overall use and safety of antihyperglycemic medications (AHMs) among patients with these comorbidities are poorly understood. METHODS AND RESULTS: Using Get With the Guidelines-Heart Failure and linked Medicare Part D data, we assessed AHM use within 90 days of hospital discharge among HF patients with diabetes mellitus discharged from Get With the Guidelines-Heart Failure hospitals between January 1, 2006, and October 1, 2011...
July 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27418265/development-implementation-and-outcome-analysis-of-semi-automated-alerts-for-metformin-dose-adjustment-in-hospitalized-patients-with-renal-impairment
#12
David Niedrig, Regina Krattinger, Annika Jödicke, Carmen Gött, Guido Bucklar, Stefan Russmann
PURPOSE: Overdosing of the oral antidiabetic metformin in impaired renal function is an important contributory cause to life-threatening lactic acidosis. The presented project aimed to quantify and prevent this avoidable medication error in clinical practice. METHODS: We developed and implemented an algorithm into a hospital's clinical information system that prospectively identifies metformin prescriptions if the estimated glomerular filtration rate is below 60 mL/min...
July 14, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27425264/can-an-early-diagnostic-procedure-of-metformin-associated-lactic-acidosis-in-an-emergency-unit-reduce-mortality
#13
Damien Sémely, Emily Bennett, Christine Vallejo, Franck Saint-Marcoux, Louis Merle, Yves Nouaille, Gérard Lachâtre, Marie-Laure Laroche
OBJECTIVE: Metformin-associated lactic acidosis (MALA) is a rare but serious adverse reaction with a mortality rate of up to 50%. Unfortunately, diagnosis and care management are often delayed. The objective was to assess the impact on the mortality rate and length of hospital stay of a MALA early diagnosis procedure in diabetic patients with metformin at emergency department (ED) admission. METHOD: From 1/7/2012, a new MALA diagnosis procedure (pH, lactate, metformin) was implemented in all diabetic patients with metformin just after their admission to the ED...
June 16, 2016: Thérapie
https://www.readbyqxmd.com/read/27458565/metformin-associated-lactic-acidosis-in-auckland-city-hospital-2005-to-2009
#14
Imad Haloob, Janak R de Zoysa
AIM: To determine the incidence, clinical characteristics and outcomes of patients with metformin associated lactic acidosis (MALA). METHODS: Auckland City Hospital drains a population of just over 400000 people. All cases presenting with metabolic acidosis between July 2005 and July 2009 were identified using clinical coding. A retrospective case notes review identified patients with MALA. Prescribing data for metformin was obtained from the national pharmaceutical prescribing scheme...
July 6, 2016: World Journal of Nephrology
https://www.readbyqxmd.com/read/27413017/risk-of-hypoglycaemia-in-users-of-sulphonylureas-compared-with-metformin-in-relation-to-renal-function-and-sulphonylurea-metabolite-group-population-based-cohort-study
#15
Judith van Dalem, Martijn C G J Brouwers, Coen D A Stehouwer, André Krings, Hubert G M Leufkens, Johanna H M Driessen, Frank de Vries, Andrea M Burden
OBJECTIVE:  To determine the association between use of sulphonylureas and risk of hypoglycaemia in relation to renal function and sulphonylurea metabolic group compared with use of metformin. DESIGN:  Population based cohort study using routinely collected data from general practices in England. SETTING:  Clinical Practice Research Datalink (CPRD) database, 2004-12. PARTICIPANTS:  120 803 new users of a non-insulin antidiabetic agent with at least one prescription and aged 18 years or more...
2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27214299/metformin-non-glycemic-effects-and-potential-novel-indications
#16
Abeer Anabtawi, John M Miles
Metformin is the most commonly prescribed drug for the treatment of type 2 diabetes because of its apparent robust effects in reducing cardiovascular risk. The United Kingdom Prospective Diabetes Study suggests that metformin reduces the risk of myocardial infarction, and more recent retrospective studies have shown an association between metformin and a reduction in stroke, atrial fibrillation and all-cause mortality. The mechanism(s) explaining these putative benefits are not clear but may involve decreased energy intake (with attendant weight loss), improvement in lipids, and lowering of blood pressure; a review of selected literature suggests that metformin lowers blood pressure when it is elevated, but not when it is normal...
May 23, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27374392/-metformin-and-kidney
#17
Concetto Sessa, Julien Blanco, Antonio Granata, Pasquale Fatuzzo, Pietro Castellino, Luca Zanoli
Metformin is the first choice among drugs used for the treatment of type II diabetes mellitus mainly because of several advantages: proven hypoglycemic effect, good safety profile, virtually no risk of hypoglycemia, body weight reduction, lipid-lowering effect, efficacy in preventing micro- and macrovascular complications as well as adverse cardiac and cerebrovascular events and reduced cost. Previous reports had shown an increased risk of lactic acidosis in patients receiving metformin. However, the current Guidelines have greatly limited this risk to certain categories of patients, such as those with severe chronic renal failure, particularly when predisposing risk factors such as administration of iodinated contrast are present...
May 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/27330130/should-restrictions-be-relaxed-for-metformin-use-in-chronic-kidney-disease-yes-they-should-be-relaxed-what-s-the-fuss
#18
George L Bakris, Mark E Molitch
Metformin is and has been considered as first-line therapy for type 2 diabetes for over a quarter of a century. Like other biguanides, metformin can cause a lactic acidosis that is exceptionally rare but fatal. The likelihood of metformin-associated lactic acidosis is substantially higher in patients with kidney impairment and also among those with seemingly normal kidney function who are at risk of acute kidney injury (AKI). Hence, regulatory agencies in many industrialized nations have maintained strict renal restrictions surrounding metformin...
July 2016: Diabetes Care
https://www.readbyqxmd.com/read/27330129/should-restrictions-be-relaxed-for-metformin-use-in-chronic-kidney-disease-no-we-should-never-again-compromise-safety
#19
Kamyar Kalantar-Zadeh, Csaba P Kovesdy
Metformin is and has been considered as first-line therapy for type 2 diabetes for over a quarter of a century. Like other biguanides, metformin can cause a lactic acidosis that is exceptionally rare but fatal. The likelihood of metformin-associated lactic acidosis is substantially higher in patients with kidney impairment and also among those with seemingly normal kidney function who are at risk of acute kidney injury (AKI). Hence, regulatory agencies in many industrialized nations have maintained strict renal restrictions surrounding metformin...
July 2016: Diabetes Care
https://www.readbyqxmd.com/read/26800971/metformin-associated-lactic-acidosis-mala-clinical-profiling-and-management
#20
Alessandra Moioli, Barbara Maresca, Andrea Manzione, Antonello Maria Napoletano, Daniela Coclite, Nicola Pirozzi, Giorgio Punzo, Paolo Menè
Metformin (MF) accumulation during acute kidney injury is associated with high anion gap lactic acidosis type B (MF-associated lactic acidosis, MALA), a serious medical condition leading to high mortality. Despite dose adjustment for renal failure, diabetic patients with chronic kidney disease (CKD) stage III-IV are at risk for rapid decline in renal function by whatever reason, so that MF toxicity might arise if the drug is not timely withdrawn. Sixteen consecutive patients were admitted to our Hospital's Emergency Department with clinical findings consistent with MALA...
December 2016: Journal of Nephrology
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