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Metformin-associated lactic acidosis (MALA) is a uncommon however severe opposed impact of the diabetes drug metformin through which the physique accumulates an excessive amount of lactic acid. Investigators developed and examined a protocol for analysis and remedy of MALA. Their work can be introduced at ASN Kidney Week 2025 from November 5–9.
The protocol, which included instant initiation of dialysis utilizing both intermittent hemodialysis, steady kidney alternative remedy, or peritonealdialysis as remedy, was applied at Maharat Nakhonratchasima hospital (MNRH), in Thailand. One other hospital, Burirum Hospital (BH), didn’t implement the protocol. A complete of 347 instances have been included over 5 years (70 in MNRH pre-intervention, 129 in MNRH intervention, and 148 in BH).
In MNRH, the 30-day mortality charge was lowered from 25.7% to 13.9% after implementing the protocol, whereas in BH the 30-day mortality charge was not lowered throughout the identical interval (27.2% and 30%). The development of mortality charge in MNRH in the course of the intervention interval decreased by -2.08% per quarter. The typical door-to-dialysis time—the interval between a affected person’s hospital admission and the initiation of dialysis—was lowered from 870 minutes to 690 minutes, and MALA consciousness elevated from 38.5% to 89.9% after implementation.
“A standardized MALA protocol covering diagnosis, access, and treatment shortened door-to-dialysis time, increased awareness, and reduced care variation,” stated corresponding creator Watanyu Parapiboon, MD, of Maharat Nakhon Ratchasima Hospital, in Thailand. “Fast-track dialysis pathways should be adopted for time-sensitive conditions like MALA. Availability of all dialysis modalities ensures flexibility and enables timely treatment initiation.”
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American Society of Nephrology
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High quality enchancment intervention might assist forestall deaths from metformin-associated lactic acid (2025, November 8)
retrieved 8 November 2025
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