SAM HULL, M.D.
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To the editor: Two articles in the November 1977 issue presented conflicting advice on whether dialysis is an effective means of removing phenformin when its use is associated with lactic acidosis. Bennett, Plamp, and Porter (1) say, "Treatment with dialysis may both correct the metabolic acidosis and effect phenformin removal (molecular weight, 206)." Misbin (2) points out that phenformin is poorly dialyzable: ". . . 1 to 2 mg/h for hemodialysis and about 0.05 mg/h for peritoneal dialysis." Although both authors agree that dialysis will remove the excess lactic acid, there appears to be some debate about the efficacy of
HULL S. Phenformin, Lactic Acidosis, and Dialysis. Ann Intern Med. 1978;88:432. doi: https://doi.org/10.7326/0003-4819-88-3-432_2
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Published: Ann Intern Med. 1978;88(3):432.
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