Metformin associated lactic acidosis in Auckland City Hospital 2005 to 2009

Table 1 Patients on presenting with lactic acidosis and sepsis

	All patients	Patients on metformin
No. of patients	32	7
Age (yr)1	22-85	46-81
Sex	19 females	4 female
Ethnicity	19 Europeans,	3 Europeans,
	9 Pacific People,	3 Pacific People
	1 NZ Maori,
	1 Indian
	2 Chinese
Baseline Creatinine (μmol/L)	41-200	58-140
2eGFR mL/min per 1.73 m2	25-90	31-87
Creatinine at presentation (μmol/L)	50-600	103-463
Number who died	15	3
Number receiving acute haemodialysis	Three	Nil
Creatinine at discharge (μmol/L)	53-245	56-60
eGFR mL Tab/min per 1.73 m2	22-90	77-90

¹The age of the patient is rounded down to the nearest year;

²eGFR: The estimated glomerular filtration rate based on the four variable MDRD formula[12]. eGFR: Estimated glomerular filtration rate; MDRD: Modification of diet in renal disease.

Table 2 Demographic and clinical details of patients with metformin associated lactic acidosis

Patients	1	2	3	4	5	6	7	8	9	10
Age (yr)1	68	53	68	63	80	40	83	55	67	72
Sex	Male	Male	Male	Female	Male	Female	Female	Female	Female	Female
Ethnicity	Pacific Islander	Indian	European	Pacific Islander	Pacific Islander	Pacific Islander	Pacific Islander	Pacific Islander	European	European
Metformin dose (g/d)	2.5	1.7	2	3	2	2	1	2	1.7	1
Duration of Metformin2	5 yr	4 yr	5 yr	4 yr	2 yr	1 yr	4 yr	4 yr	4 yr	2 mo
Baseline Creatinine (μmol/L)	114	57	138	123	106	123	180	105	154	139
3eGFR mL/min per 1.73 m2	55	130	44	38	58	42	23	47	29	32
Creatinine at Presentation (μmol/L)	449	90	333	612	381	612	376	895	973	304
pH	7.3	7.23	7.14	7.32	6.99	7.21	7.34	6.9	7.35	7.09
Bicarbonate (mmol/L)	15	13	13	16	6	12	12	3	15	15
Lactate (mmol/L)	9.2	6.7	15	6	16	8.4	6	22	6.2	7
Received acute haemodialysis	Yes	No	Yes	No	No	No	No	No	Yes	No
Outcome	Dead	Alive	Alive	Alive	Dead	Alive	Alive	Alive	Alive	Alive
Creatinine at discharge (μmol/L)	-	73	121	95	-	90	167	123	129	96
3eGFR mL/min per 1.73 m2	-	97	52	52	-	60	25	39	36	50

¹The age of the patient is rounded down to the nearest year;

²The duration of metformin is rounded down to completed years of therapy, except for patient 10;

³eGFR: The estimated glomerular filtration rate based on the four variable MDRD formula[12]. eGFR: Estimated glomerular filtration rate; MDRD: Modification of diet in renal disease.