Metformin-Associated Lactic Acidosis and Acute Kidney Injury

Diabetes mellitus is a common disease worldwide. Metformin is included in the first-line treatment of type 2 diabetes mellitus. Metformin-associated lactic acidosis (MALA) is rare but can be life-threatening. In this case report, MALA and acute kidney injury (AKI) were detected in a 74-year-old female patient who presented with impaired consciousness. The patient was treated with hydration and hemodialysis (HD). MALA diagnosis was based on metformin levels > 5 mg/L, decreased pH, low bicarbonate levels, lactate levels > 5 mmol/L, and increased anion gap.