UNASSIGNED: @entity2449 (MF) accumulation during @entity810 is associated with high anion gap @entity8193 type B (MF-associated @entity8193 , MALA), a serious medical condition leading to high mortality. Despite dose adjustment for @entity177 , @entity6 @entity1 with @entity740 ( @entity740 ) stage III-IV are at risk for rapid decline in renal function by whatever reason, so that @entity137 might arise if the drug is not timely withdrawn. Sixteen consecutive @entity1 were admitted to our Hospital's Emergency Department with clinical findings consistent with MALA. Fifteen had prior history of @entity740 , 60  % of them with GFR between 30 and 60  ml/min. Of these, 5 required mechanical ventilation and cardiovascular support; 3 promptly recovered renal function after rehydration, whereas 10 (62  %) required continuous veno-venous renal replacement treatment. SOFA and SAPS II scores were significantly related to the degree of @entity8193 . In addition, @entity880 levels were relevant to therapeutic choices, since they were higher in dialyzed @entity1 than in those on conservative treatment (11.92  mmol/l vs 5.7  mmol/l, p  =  0.03). The overall death rate has been 31  %, with poorer prognosis for worse @entity2185 , as serum pH was significantly lower in non-survivors (pH 6.96 vs 7.16, p  >  0.04). Our own data and a review of the literature suggest that aged, hemodynamically frail @entity1 , with several comorbidities and @entity740 , are at greater risk of MALA, despite MF dosage adjustment. Moreover, renal replacement therapy rather than simple acidosis correction by administration of alkali seems the treatment of choice, based on eventual renal recovery and overall outcome.

XXXX associated @entity8193 (MALA): clinical profiling and management.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity137 :: ('MESH:D064420', 'Disease') :: ['MF toxicity'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetic'] @entity2185 :: ('MESH:C537358', 'Disease') :: ['acidemia'] @entity740 :: ('MESH:D051436', 'Disease') :: ['CKD', 'chronic kidney disease'] @entity8193 :: ('MESH:D000140', 'Disease') :: ['lactic acidosis'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure'] @entity880 :: ('MESH:D019344', 'Chemical') :: ['lactate'] @entity810 :: ('MESH:D058186', 'Disease') :: ['acute kidney injury'] @entity2449 :: ('MESH:D008687', 'Chemical') :: ['Metformin']
@entity2449 :: (MESH:D008687,Chemical) :: ['Metformin']
