Lactic Acidosis: Recovery Associated with Use of Peritoneal Dialysis

Abstract

Summary: A case of severe lactic acidosis associated with phenformin therapy for diabetes mellitus and generalised atherosclerosis is described. The patient was treated with peritoneal dialysis, using solutions containing acetate, in addition to the standard treatment of intravenous bicarbonate, rehydration and methylene blue. It was probable that peritoneal dialysis contributed to the patient's survival. There was clear evidence that peritoneal dialysis was an effective means of removal of lactate from the plasma suggesting that lactate removal was partially responsible for the patient's recovery. Other factors possibly involved included the making available of a large amount of buffer.