Abstract：
BACKGROUND:Lactic acidosis is a widely recognized, though rare, side effect of metformin. This paper describes five patients admitted to Chang Gung Memorial Hospital from 1 September 1998 to 31 May 2001 suffering severe lactic acidosis caused by metformin, and reviews the literature. PATIENTS:Five cases diagnosed as having meftormin-associated lactic acidosis (MALA) were discovered during the study period. Three had normal renal function before the onset of MALA and two had attempted suicide bytaking large amounts of metformin. One patient with end-stage renal disease developed MALA despite regularhemodialysis three times a week. One of the patients who had taken metformin to attempt suicide was not diabetic. RESULTS:All patients suffered severe metabolic acidosis with a high anion gap and blood lactate level. Four developed profound hypotension, and three of these also suffered acute respiratory failure. Three patients received conventional hemodialysis and two continuous renal replacement therapy. A young non-diabetic female who had taken a large dose of metformin to commit suicide died from multiple organ failure despite aggressive treatment. CONCLUSIONS:Lactic acidosis is a serious reaction to metformin, and hemodialysis (the treatment of choice) should be done urgently to prevent serious complications. MALA should be suspected in patients presenting with wide anion gap metabolic acidosis and high blood lactate, even when they are non-diabetic.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Chang CT,Chen YC,Fang JT,Huang CCsubject
Has Abstractpub_date
2002-07-01 00:00:00pages
398-402issue
4eissn
1121-8428issn
1724-6059journal_volume
15pub_type
杂志文章,评审abstract：:Patients with type 2 diabetes run a high risk for progressive renal function loss. Many interventions have been tested to reduce the risk, but we are nowadays still confronted with a high unmet need. To improve on this unmet need, we will have to change the current strategies in drug discovery, clinical trials and cli...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-020-00820-2
更新日期：2020-12-01 00:00:00
abstract：:Recent molecular cloning experiments have identified the existence of four NBC isoforms (NBC1, 2, 3 and 4) and two NBC-related proteins AE4 and NCBE (Anion Exchanger 4 and Sodium-dependent Chloride-Bicarbonate Exchanger). Except for AE4 which does not transport Na, all are presumed to mediate the cotransport of Na+ an...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2002-03-01 00:00:00
abstract：:The pathophysiological mechanisms underlying preeclampsia, a serious complication of pregnancy, are largely unknown. Since, on the other hand, the various risk factors are known, primary and secondary prevention with pre- and inter-pregnancy counseling should be undertaken, and a follow-up should be conducted to evalu...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2008-09-01 00:00:00
abstract：:Hyperlipidaemia complicating the nephrotic syndrome is characterised by elevated levels of total and LDL cholesterol, often with hypertriglyceridaemia and low HDL cholesterol levels. The underlying mechanisms are complex but involve abnormalities of both lipoprotein synthesis and catabolism. Experience to date suggest...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2001-11-01 00:00:00
abstract：BACKGROUND:Improved responsiveness to erythropoiesis stimulating agents (ESAs) in patients on on-line post-dilution hemodiafiltration (Post-HDF) compared with conventional hemodialysis (HD) was reported by some authors but challenged by others. This prospective, cross-over randomized study tested the hypothesis that an...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-020-00709-0
更新日期：2020-10-01 00:00:00
abstract：INTRODUCTION:Lack of adherence may influence the efficiency of phosphate binders. Our clinical hypothesis was that if lanthanum carbonate (LC) might offer some advantage over sevelamer (S), that that would be in those patients in whom serum phosphate (P) levels were not controlled by S or in those requiring high doses ...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2010-11-01 00:00:00
abstract：:In this paper we concentrate on the role of infections in IgA nephropathy both from a pathogenetic and clinic point of view. The current hypotheses as regards the role of infections in the pathogenesis of IgA nephropathy are: (a) role of particular pathogens, (b) chronic exposure to mucosal infections, (c) abnormal ha...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-016-0265-x
更新日期：2016-08-01 00:00:00
abstract：:Evidence-based medicine provides tools to evaluate dialysis outcomes by integrating knowledge obtained from interventional and observational studies. This is illustrated in relation to three important topics: dialysis membranes, dialysis dose and anemia. Clinical trials and observational evidence support each other in...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2001-11-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Peritonitis is the major cause of peritoneal dialysis (PD) technique failure. Prophylactic topical antibiotics have been reported to reduce peritoneal dialysis catheter exit site infections (ESI) and peritonitis rates. METHODS:We audited the effect of different exit site practices in the 12 P...
journal_title：Journal of nephrology
pub_type： 杂志文章,多中心研究
doi：10.5301/jn.5000071
更新日期：2012-09-01 00:00:00
abstract：:Hypertension is a risk factor for cardiovascular and renal organ damage. Environmental conditions affect the development of high blood pressure (BP), although genetic influences are also important. Current international guidelines recommend reducing dietary sodium to no more than 100 mmol (about 2.4 g sodium or approx...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2002-01-01 00:00:00
abstract：:The goal of palliative care is to achieve good quality of life for patients with chronic life-limiting illnesses, and their families, through assessment and management of physical, psychosocial and spiritual problems and needs. Patients with kidney diseases present a particular target of such care from the time of dia...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2008-03-01 00:00:00
abstract：:Modern nephrology developed in Poland mostly from the internal medicine department chaired in Warsaw by the great internist prof. Witold Orłowski (1874-1966). Three of his pupils Tadeusz Orłowski, Jan Roguski and Jakub Penson independently established the foundations of clinical nephrology and renal replacement therap...
journal_title：Journal of nephrology
pub_type： 历史文章,杂志文章
doi：
更新日期：2006-05-01 00:00:00
abstract：:One of the central functions of the kidney is to excrete low molecular weight, water soluble, plasma, waste products into the urine, whereas macromolecules, the size of albumin and larger, are retained. The flow of the glomerular filtrate is thought to follow an extracellular route, passing through the endothelial fen...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2003-11-01 00:00:00
abstract：:The partial correction of anemia and the normalization of phosphate and blood pressure are the mainstay of treatment of patients with chronic kidney disease (CKD). Available anti-hypertensive drugs, erythropoiesis stimulating agents (ESAs) and iron supplements have resolved quite satisfactorily the goal of controlling...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-017-0421-y
更新日期：2017-12-01 00:00:00
abstract：BACKGROUND AND AIMS:Reduction of intestinal load of phosphorus is important for the prevention and treatment of chronic kidney disease (CKD)-mineral and bone disorder (MBD). However, this strategy is limited by patients' poor adherence to dietary prescription and by the existence of hidden sources of phosphorus. In add...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-016-0306-5
更新日期：2016-12-01 00:00:00
abstract：INTRODUCTION:We analyzed renal histologic and immunohistologic findings in children with nephrotic syndrome (NS) who did (n=5) or did not (n=17) develop cyclosporine A (CyA) nephropathy despite appropriately low serum CyA concentrations being maintained over 2 years. METHODS:To discriminate embryonic-type from mature ...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.5301/JN.2010.5793
更新日期：2011-07-01 00:00:00
abstract：:Membranous nephropathy (MN) is a glomerular disease characterized by proteinuria, usually in a nephrotic range, and variable natural course. The etiology is unknown in many cases, while in some patients, MN may be secondary to infection, to other diseases, or to exposure to drugs and toxic substances. In idiopathic MN...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2007-05-01 00:00:00
abstract：:We report 4 cases of sepsis-induced acute renal failure (ARF) with peculiar clinical presentation in which the renal biopsy was the only clue to a correct diagnosis. We observed 66 cases of ARF in a 4-year experience. Seven (11%) were associated with sepsis; in 3 of these (4.5%) a shock was present. Clinical picture o...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：1998-09-01 00:00:00
abstract：:The study was conducted to determine the association between mortality, rurality, and distance from the treatment facility of the patients with ESRD. The United States Renal Data System (USRDS) for the year 2007-08 was utilized to conduct analysis of 181,349 subjects. After adjusting for all other covariates, the odds...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-016-0324-3
更新日期：2016-12-01 00:00:00
abstract：:Rapidly progressive glomerulonephritis (RPGN) must be diagnosed and treated quickly to prevent irreversible organ injury. The commonest cause of RPGN is anti-neutrophil cytoplasm antibody (ANCA) associated small vessel vasculitis, and the most severe is anti-glomerular basement membrane (GBM) antibody disease. In this...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2004-11-01 00:00:00
abstract：BACKGROUND:Non-heart-beating donors suffer a period of warm ischaemia (WI) injury, resulting in higher rates of delayed graft function compared with heart-beating donors. Endothelin is believed to play a pathophysiological role in the intense vasospasm associated with WI. This study aimed to investigate renal function ...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:IgA nephropathy is one of the most common primary glomerulonephritides, and the clinical course of almost 40% of the patients progresses to end-stage renal disease (ESRD) within 20 years. Angiotensin-converting enzyme (ACE) inhibitors and/ or angiotensin II receptor blockers (ARBs) induce a marked renoprotec...
journal_title：Journal of nephrology
pub_type： 杂志文章,多中心研究,随机对照试验
doi：
更新日期：2009-03-01 00:00:00
abstract：BACKGROUND AND AIMS:Encapsulating peritoneal sclerosis (EPS) is an uncommon but severe complication of peritoneal dialysis (PD). A reliable screening tool to identify patients at risk of developing or not EPS is currently not available. We aimed to evaluate whether the reduction in dialysate sodium concentration (sodiu...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-016-0371-9
更新日期：2018-02-01 00:00:00
abstract：:Nephrogenic systemic fibrosis (NSF) / nephrogenic fibrosing dermopathy (NFD) is a recently described disease, occurring only in patients with variable degrees of renal failure (RF) previously exposed to gadolinium-based contrast agents (GBCAs) for magnetic resonance imaging. Public advisories are consistent on some ke...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2008-05-01 00:00:00
abstract：:Aim of the study was the definition of a predictive model for the initial diagnosis of thrombotic microangiopathies (TMA). We retrospectively collected data on all adult patients admitted to the Gemelli Hospital from 2010 to 2014. ICD-9 codes from primary diagnoses were used for TMA diagnosis. Demographic and laborato...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-018-0468-4
更新日期：2018-06-01 00:00:00
abstract：AIMS:This joint document of the Italian Diabetes Society and the Italian Society of Nephrology reviews the natural history of diabetic kidney disease (DKD) in the light of the recent epidemiological literature and provides updated recommendations on anti-hyperglycemic treatment with non-insulin agents. DATA SYNTHESIS:...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-019-00650-x
更新日期：2020-02-01 00:00:00
abstract：BACKGROUND:Coronary artery disease (CAD) and chronic kidney disease (CKD) lead to high morbidity and mortality rates. Traditional and nontraditional risk factors, hypertension, fluid overloading and anemia can lead to myocardial ischemia, chamber hypertrophy and dilatation, and low left ventricular ejection fraction (L...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2010-03-01 00:00:00
abstract：:Cell-to-cell signal exchange during antigen presentation deeply influences the profile and extent of the immune response. Together with the TCR/MHC-mediated signal, accessory signals are provided to the T cell by the antigen-presenting cell (APC), through specific receptor-ligand interactions that represent indispensa...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2002-01-01 00:00:00
abstract：:We followed up 128 patients with crescentic glomerulonephritis (CGN), having sufficient clinical and histopathological data for a mean period of 34 +/- 28 months. There were 49 males and 79 females, mean age 22.7 +/- 14 years. We studied the effects of clinical, laboratory and histopathological parameters on kidney fu...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2002-05-01 00:00:00
abstract：:Rapidly progressive glomerulonephritis (RPGN) is a rare occurrence in IgA nephropathy (IgAN) in renal transplant patients on immunosuppressive therapy. RPGN post ischemia-reperfusion has not been previously reported. We report a 62 year old male patient on azathioprine therapy, 9 years after left cadaveric renal trans...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2004-01-01 00:00:00
