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High-volume continuous venovenous hemodiafiltration plus resin hemoperfusion improve severe metformin-associated toxicity.

High-volume continuous venovenous hemodiafiltration plus resin hemoperfusion improve severe metformin-associated toxicity.
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Liu S, Xu L, Ma J, Huang R, Lin T, Li Z, Liang H, Li S, Li R, Zhang L, Tao Y, Li Z, Chen Y, Ye Z, Zhang B, Wang W, Xiao H, Liang X, Shi W,


Liu S, Xu L, Ma J, Huang R, Lin T, Li Z, Liang H, Li S, Li R, Zhang L, Tao Y, Li Z, Chen Y, Ye Z, Zhang B, Wang W, Xiao H, Liang X, Shi W, (click to view)

Liu S, Xu L, Ma J, Huang R, Lin T, Li Z, Liang H, Li S, Li R, Zhang L, Tao Y, Li Z, Chen Y, Ye Z, Zhang B, Wang W, Xiao H, Liang X, Shi W,

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Journal of diabetes investigation 2017 10 05() doi 10.1111/jdi.12757
Abstract

We present the case of a 42-year-old female patient who attempted suicide by taking approximately 100 tablets of metformin (500 mg). Laboratory tests revealed severe lactic acidosis with lactate levels of 24 mmol/L and pH of 7.09. The patient was treated with high-volume continuous venovenous hemodiafiltration (CVVH) and resin-sorbent hemoperfusion. Metformin concentrations were measured by high-performance liquid chromatography (HPLC) during CVVH and hemoperfusion treatment. Before extracorporeal treatment, plasma metformin concentration was 208.5 mg/L. After CVVH treatment for 24 hours, plasma metformin concentration had decreased to 13.9 mg/L. Resin-based sorbent hemoperfusion (HA230) plus CVVH treatment had reduced the metformin plasma concentration by 61.8% after 3 hours. After 7 days, the patient’s laboratory tests and clinical syndrome were improved and she was discharged from hospital. We provide evidence that CVVH plus hemoperfusion is effective in eliminating metformins and metabolic products. This article is protected by copyright. All rights reserved.

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