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Clinical risk associated with contrast angiography in metformin treated patients: a clinical review

Nawaz, S., Cleveland, T., Gaines, P.A., Chan, P. (1998) Clinical risk associated with contrast angiography in metformin treated patients: a clinical review. Clinical Radiology, 53 (5). pp. 342-344. ISSN 0009-9260. (doi:10.1016/S0009-9260(98)80005-6) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:78368)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided.
Official URL:
https://doi.org/10.1016/S0009-9260(98)80005-6

Abstract

Recently, concern has been expressed about the hazards of lactic acidosis following the use of intravascular iodinated contrast agents in patients taking metformin. In response the Royal College of Radiologists have issued guidelines for the management of these patients. We have reviewed the reported cases of lactic acidosis and identified that in all cases underlying renal impairment existed. To examine this further we reviewed the notes of 33 in-patients receiving metformin who underwent contrast angiography in our hospital. Twenty-nine patients had a normal serum creatinine prior to the procedure and none had a rise following angiography. Four patients had an abnormal serum creatinine prior to angiography, all four patients showed significant deterioration and all four patients died, two from unrelated causes and two from acute renal failure and acidosis. These data strongly highlight the hazards of intravascular contrast radiology in diabetic patients with pre-existing renal impairment. We have failed to find evidence in support of the Royal College of Radiologists recommendation; instead we recommend that in those patients taking metformin with evidence of renal impairment metformin should be stopped and diabetic control obtained using alternative therapy before proceeding with angiography. Patients with normal renal function taking metformin are not at risk of lactic acidosis following the use of iodinated contrast agents for angiography.

Item Type: Article
DOI/Identification number: 10.1016/S0009-9260(98)80005-6
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
Depositing User: Philip Chan
Date Deposited: 08 Nov 2019 10:09 UTC
Last Modified: 14 Dec 2023 04:15 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/78368 (The current URI for this page, for reference purposes)

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