Evidence Hub

Dancing with death at pH 6.8 and lactate of 29 mmol/L: extreme survival in severe metformin-associated lactic acidosis - a case report

Kortli S, Amathieu R, Ghalayini M

Frontiers in medicine, 2025

Abstract

Lactic acidosis is a serious metabolic disorder characterized by an accumulation of lactate in the body, which can lead to a severe acid-base imbalance. Metformin-associated lactic acidosis is a rare but life-threatening complication of metformin therapy, particularly in the setting of acute kidney injury or other conditions that impair lactate clearance. In this case report, we present the remarkable survival of a patient who experienced severe metformin-associated lactic acidosis with a blood pH of 6.8 and a lactate level of 29 mmol/L, which are typically considered incompatible with life.

How strong is the evidence?

Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free