Lactic Acidosis

Acidosis caused by accumulation of lactic acid more rapidly than it can be metabolized. It may occur spontaneously or in association with diseases such as diabetes mellitus, leukemia, or liver failure.

Also Known As:

Networked: 2903 relevant articles (91 outcomes, 160 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Stroke (Strokes)
2.	Hypoglycemia (Reactive Hypoglycemia)
3.	Renal Insufficiency (Renal Failure)
4.	Mitochondrial Encephalomyopathies (Mitochondrial Encephalomyopathy)
5.	Mitochondrial Myopathies (Mitochondrial Myopathy)

Experts

1.	Taylor, Robert W: 13 articles (01/2015 - 10/2002)
2.	Stacpoole, Peter W: 11 articles (06/2013 - 04/2003)
3.	Zeviani, Massimo: 10 articles (03/2014 - 01/2002)
4.	Hirano, Michio: 9 articles (02/2013 - 03/2005)
5.	Wong, Lee-Jun C: 9 articles (02/2012 - 12/2002)
6.	Prokisch, Holger: 8 articles (07/2015 - 08/2011)
7.	Haack, Tobias B: 7 articles (07/2015 - 08/2011)
8.	Santorelli, Filippo M: 7 articles (03/2015 - 04/2003)
9.	Mayr, Johannes A: 7 articles (01/2015 - 04/2010)
10.	Wong, Lee-Jun: 7 articles (11/2014 - 03/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Lactic Acidosis:

1.	Lactic AcidFDA LinkGeneric 08/01/1999 - "The present study was designed to investigate the efficacy of control of lactic acidosis by immunisation against lactic acid-producing bacteria, Streptococcus bovis and Lactobacillus. " 10/01/2006 - "Hemofiltration was titrated upward until lactic acidosis resolved, through clearance of lactate or interruption of excess cytokine-driven activity; maximum prescription was 2000 mL/h ultrafiltrate production plus 2500 mL/h dialysate flow. " 02/01/1983 - "The D-lactic acidosis was cleared using antibiotic therapy, suggesting that D-lactate is produced from fermentation of ingested carbohydrate by colonic bacteria. " 08/01/2011 - "Our study showed that pH-weighted MRI can detect ischemic lesions and strongly correlates with tissue lactate content measured by (1)H MRS, indicating lactic acidosis. " 06/01/2002 - "This study evaluated the reliability and validity of the lactate minimum test (LMT), an incremental test given after lactic acidosis was induced by sprint exercise. "
2.	Metformin (Glucophage)FDA LinkGeneric 12/01/2008 - "Until recently, metformin was contraindicated in patients with HF because of the potential risk of lactic acidosis; however, recent retrospective studies of metformin use in HF patients have shown that this medication may be used safely and indeed may be beneficial in patients with stable HF. " 09/01/2005 - "In this report of a near-fatal metformin ingestion successfully treated with alkalinization and high-volume hemofiltration, we discuss the management of severe lactic acidosis and demonstrate that early aggressive intervention resulted in a positive outcome. " 03/01/2000 - "In France, Information given to physicians, pharmacists and patients on the risk of lactic acidosis where Glucophage is implicated must be improved, and on the interest of the metformin plasma level in this case. " 03/27/2015 - "The aim of this study was to further investigate the clinical profiles and risk factors for metformin-associated lactic acidosis (MALA) and the treatment modalities according to survival. " 12/24/2014 - "The overall incidence of lactic acidosis in metformin users varies across studies from approximately 3 per 100,000 person-years to 10 per 100,000 person-years and is generally indistinguishable from the background rate in the overall population with diabetes. "
3.	Dichloroacetate (Dichloroacetic Acid)IBA 01/01/1988 - "Sodium dichloroacetate (NaDCA) has been used successfully to treat clinical and experimentally-induced lactic acidosis. " 05/01/2006 - "Open-label studies indicate that oral dichloroacetate (DCA) may be effective in treating patients with congenital lactic acidosis. " 08/18/1983 - "We conclude that dichloroacetate is a safe and effective adjunct in the treatment of patients with lactic acidosis, although the ultimate prognosis may depend on the underlying disease." 01/01/1990 - "Reduction in spinal cord postischemic lactic acidosis and functional improvement with dichloroacetate." 04/01/1986 - "Although dichloroacetate (DCA) ameliorates type B lactic acidosis, its effectiveness in type A hypoxic lactic acidosis is uncertain on both theoretical and experimental grounds. "
4.	Phenformin (Fenformin)IBA 04/01/1998 - "Efficacy of continuous venovenous haemofiltration (CVVH) in the treatment of severe phenformin-induced lactic acidosis." 12/01/1983 - "The results may help to explain lactic acidosis in patients given phenformin in the absence of other predisposing factors." 09/01/1979 - "Detailed hemodynamic and metabolic studies were performed during the course of phenformin related lactic acidosis in two patients. " 07/01/2013 - "Phenformin was removed from the markets before 1970, because it caused lactic acidosis in 40-65 patients in 100,000 patient-years. " 03/01/2013 - "Lactic acidosis provoked by iv infusion of phenformin was weaker in octn1(-/-) mice than that in wild-type mice. "
5.	Glucose (Dextrose)FDA LinkGeneric 06/01/2002 - "Recent studies provide evidence of direct consumption of glucose by the tumour cells, leading to lactic acidosis. " 03/12/1999 - "Plasma glucose concentration was altered in individual animals to study a range of intraischemic cerebral lactic acidosis. " 09/01/1998 - "Plasma glucose concentrations were elevated in order to study animals with severe cerebral lactic acidosis. " 01/01/1978 - "Studies on fibroblasts from patients with lactic acidosis of different causes showed secondary metabolic changes in pathways of glucose metabolism. " 03/29/2013 - "TXNIP is known to be transcriptionally regulated in response to nutrients such as glucose and stress signals, including endoplasmic reticulum stress and lactic acidosis. "
6.	OxygenIBA 11/01/2007 - "Peak oxygen uptake and lactic acidosis threshold improved significantly in the supervised groups, but differences among groups did not achieve significance. " 11/01/2010 - "This mechanism is also supported in some studies by a critically low oxygen uptake that was not associated with lactic acidosis." 07/01/2000 - "Results of a progressively increasing CPX can be used to: 1) design an exercise prescription for aerobic training in HIV+ individuals; 2) identify and refer patients with subtle abnormalities of gas exchange for further diagnostic studies to exclude early infectious complications: and 3) evaluate the improvements in maximal oxygen uptake, lactic acidosis threshold, and gas exchange kinetics as result from an aerobic exercise training program. " 09/15/2015 - "Inhibition of the oxygen sensor PHD2 in the liver improves survival in lactic acidosis by activating the Cori cycle." 08/01/2015 - "Treatment of lactic acidosis is targeted on correcting the underlying causes and optimizing adequate oxygen delivery to the tissues. "
7.	Sodium Bicarbonate (Baking Soda)FDA LinkGeneric 12/01/1991 - "Sodium bicarbonate has been thought to be effective for hypoxic lactic acidosis, but recently its adverse reactions have been pointed out. " 01/01/2013 - "This study aimed to evaluate the cause and mortality rate of lactic acidosis and to investigate the effect of factors, including sodium bicarbonate use, on death. " 01/01/2015 - "We sought to clarify this issue in patients with lactic acidosis who were supplementing with sodium bicarbonate. " 04/01/2014 - "Buffering with sodium bicarbonate is proposed in severe lactic acidosis. " 01/01/2013 - "In addition, sodium bicarbonate should be prescribed with caution in the case of lactic acidosis because sodium bicarbonate administration may affect mortality."
8.	Thiamine (Aneurin)FDA Link 02/01/1997 - "Thiamine replenishment at intravenous doses of 100 mg every 12 h resolved lactic acidosis and improved the clinical condition in 3 patients. " 01/01/1991 - "In both patients, the lactic acidosis improved immediately, and it disappeared following the second dose of thiamine. " 08/01/2005 - "Thiamine-responsive congenital lactic acidosis: clinical and biochemical studies." 05/01/2013 - "Thiamine defects should be excluded in newborns and infants with lactic acidosis because prognosis largely depends on the time from diagnosis to thiamine supplementation." 05/01/2013 - "Reversible lactic acidosis in a newborn with thiamine transporter-2 deficiency."
9.	Insulin (Novolin)FDA Link 02/01/2011 - "In addition, in spite of the fact that the insulin injection decreased blood KB, there was a risk of worsening lactic acidosis." 01/01/1975 - "For the lactic acidosis which results, insulin administration may thus constitute specific therapy. " 10/01/2010 - "Follow-up for the study was stopped on postoperative day 7. The main changes were appearing just after the HIPEC procedure: increased diuresis, lactic acidosis, hyponatremia and hyperglycaemia (despite aggressive intravenous insulin therapy). " 03/01/2013 - "The insulin-like growth factor-system in a patient with diffuse large B-cell non-Hodgkin's lymphoma and lactic acidosis." 01/01/2008 - "Type B lactic acidosis is a phenomenon that may occur in the pediatric population in conjunction with insulin-resistant hyperglycemia. "
10.	CreatinineIBA 05/15/2003 - "Two factors were associated with an increased risk of lactic acidosis: first, a creatinine clearance of <70 mL/min before lactic acidosis (OR, 15.8 [range, 3.0-86.5], P<10(-4)), and, second, a low nadir CD4+ T lymphocyte count before the inception of NRTI therapy (OR, 8.4 [range, 1.2-infinity], P=.03). " 12/01/2010 - "Given the very low incidence of lactic acidosis, the recommendation should be changed to reflect eGFR cut-off values rather than serum creatinine." 12/01/2010 - "serum creatinine >1.5 mg/dl) secondary to fear of lactic acidosis. " 11/15/2009 - "In patients without comorbid conditions that would predispose them to lactic acidosis, elevated serum creatinine levels should be considered a risk factor for the development of lactic acidosis but not an absolute contraindication." 05/15/2003 - "According to these results, monitoring of creatinine clearance, especially in patients with a low nadir CD4+ T lymphocyte count, could lead to modifications in antiretroviral therapy in order to diminish the risk of occurrence of lactic acidosis."

Therapies and Procedures

1.	Renal Dialysis (Hemodialysis) 09/01/1996 - "After hemodialysis and clearance of toxic metabolites, severe lactic acidosis persisted with multiorgan failure. " 09/01/1978 - "The efficacy of hemodialysis in the treatment of biguanide-induced lactic acidosis is difficult to evaluate. " 03/01/2015 - "The patient presented with severe lactic acidosis, which was successfully treated with hemodialysis. " 01/01/2013 - "The patients must be monitored closely for lactic acidosis and the decision to start hemodialysis must be made promptly for patients who develop lactic acidosis. " 01/01/1991 - "DCA can safely and effectively be given to hemodialysis patients who may require the drug for treatment of lactic acidosis."
2.	Drug Therapy (Chemotherapy) 05/01/1983 - "Chemotherapy against the neoplastic disease is the only effective treatment of this type of lactic acidosis." 05/01/2010 - "Chemotherapy relieved the degree of lactic acidosis initially, but as the disease progressed, lactic acidosis became aggravated. " 01/01/2015 - "In the face of a life-threatening lactic acidosis, pragmatic clinical judgement alone may justify the rapid initiation of chemotherapy." 01/01/2015 - "Veno-venous haemofiltration had no apparent effect on reducing the lactic acidosis and therefore its benefit is questioned in this setting, especially at the cost of delaying chemotherapy. " 09/01/2012 - "Two of the six patients survived their episode thanks to the early recognition of malignant lactic acidosis and the prompt administration of chemotherapy. "
3.	Resuscitation 01/01/2006 - "All resuscitation strategies restored blood pressure, but clearance of lactic acidosis was impeded following DL-LR resuscitation. " 10/05/2005 - "There is increasing recognition, however, of a group of acidotic patients who have a large anion gap that is not explained by either keto- or lactic acidosis nor, in most cases, is inappropriate fluid resuscitation or ingestion of exogenous agents the cause. " 11/01/1999 - "In the prospective study, patients with two consecutive LA levels greater than 2.5 mmol/L underwent invasive monitoring and vigorous resuscitation to correct their lactic acidosis. " 11/01/1991 - "All patients underwent invasive hemodynamic monitoring followed by volume resuscitation and inotropic support to reverse flow-dependent oxygen consumption and lactic acidosis. " 12/01/1982 - "Certain aspects of these cases, such as delayed entrance into the medical care system and exercise-induced lactic acidosis, make successful resuscitation difficult. "
4.	Cardiopulmonary Resuscitation (CPR) 12/01/1987 - "Lactic acidosis during closed-chest CPR in dogs." 11/01/1985 - "The progression of acidemia was remarkably slow; arterial blood pH remained normal for more than 16 min. Even though there was significant lactic acidosis, concurrent respiratory alkalosis during CPR accounted for the greatly delayed onset of acidemia. " 02/01/1993 - "Acid-base changes occurring during cardiac arrest and subsequent CPR are related to a complex low-perfusion state characterized clinically by venous and tissue hypercarbic and metabolic (lactic) acidosis. " 11/01/1986 - "Accordingly, increased venous PCO2 rather than metabolic acidosis due to lactic acidosis predominates during the initial 8 min of cardiopulmonary resuscitation. " 05/01/1989 - "Our results during CPR demonstrate a) a significant discrepancy between arterial and mixed venous blood gases but also a large and significant discrepancy between mixed venous and myocardial venous blood gases, b) significant anaerobic systemic and myocardial metabolism, and c) that mixed venous and myocardial venous acidosis is possibly a result of lactic acidosis."
5.	Combination Drug Therapy (Combination Chemotherapy) 01/01/1978 - "The third patient responded successfully to the early initiation of combination chemotherapy with achievement of a clinical remission and correction of the lactic acidosis. " 12/01/1998 - "Fluid restriction improved SIADH, and combination chemotherapy for SCLC improved the lactic acidosis although the tumor size did not change."