What is the data on Hemodialysis or CRRT on lactic acidosis?
The above mentioned treatments are mentioned in the literature for severe lactic acidosis Type A. In one paper, the lactic acidosis resolved during treatment with bicarb based hemofiltration. Few case reports exist about using CRRT do successfully treat lactic acidosis.
However, there is a lot of doubt about the clearance of lactate. One paper studied 10 patients that were in AKI and lactic acidosis and checked stable lactate levels pre and post CRRT. They concluded that the mean lactate concentration actually increased despite renal replacement therapy. He medial total plasma lactate clearance was 1379ml/min(range 754-1881) and the median filter lactate clearance was 24ml/min suggesting that the filter lactate clearance accounted for only <3% of total lactate clearance. Hence CRRT doesn't compete with lactate overproduction. If the cause is Type B lactic acidosis and a drug induced nature or ethanol induced, removing the offending agents via dialysis might be beneficial. There are case reports of metformin induced lactic acidosis being treated with dialysis, all met with some form of skepticism.
A prior post described metformin induced lactic acidosis and role of dialysis.
- ► 2014 (71)
- ► 2013 (133)
- ► 2012 (201)
- Geriatric Nephrology
- TOPIC DISCUSSION: Ageusia and ACEI/ARBS
- Nephrology Quiz at UKidney.com
- Disorders of Sodium & Water Balance: A mathematic...
- IN THE NEWS- Idiopathic Membranous GN and HLA-DQA1...
- Skin cancer and Transplants
- TOPIC DISCUSSION: Is Veno-occlusive disease associ...
- JOURNAL CLUB: ESCAPE TRIAL
- Nephrology Anagrams
- TOPIC DISCUSSION: Renal Vein Pressures and Cardio ...
- World Kidney day
- CLINICAL CASE 33, ANSWER AND SUMMARY(IMAGE QUIZ)
- Suggest and Vote for New Ideas in Nephrology
- Risk factors for post transplant Hypertension
- TOPIC DISCUSSION: Pseudohyperphosphatemia
- TOPIC DISCUSSION: Hypercalcemia of Malignancy
- JOURNAL CLUB: BELATACEPT and Transplantation
- TOPIC DISCUSSION: Lactic acidosis and Dialysis?
- Male Fertility and Transplantation
- TOPIC DISCUSSION: Membranous and Class Type IgG
- Renal Blog in finalist for Best Medical Blog( Clin...
- TOPIC DISCUSSION: Spontaneous Perinephric Hemorrha...
- Nephsap review: Transplantation
- Acute Kidney Injury in Cancer Patients
- CLINICAL CASE 32, ANSWERS AND SUMMARY
- ▼ February (25)
- ► 2010 (461)