Nickan Research Institute Journal of Renal Injury Prevention 2345-2781 13 4 2024 12 01 Renal manifestations of metformin-associated lactic acidosis; new findings e32258 e32258 10.34172/jrip.2024.32258 EN Parisa Tajdini Majid Foroutan https://orcid.org/0000-0002-3691-2365 Journal Article 10.34172/jrip.2024.32258 2023 10 22 2023 12 22 Risk factors for metformin-associated lactic acidosis (MALA) include impaired renal function, liver disease, heart failure, sepsis, and alcohol abuse. Patients with these risk factors should be closely monitored while on metformin therapy, and the dose should be adjusted accordingly. It is also important to screen patients for these risk factors before starting metformin therapy. In addition, patients should be educated on the symptoms of lactic acidosis, such as abdominal pain, nausea, vomiting, and muscle weakness, and advised to seek medical attention immediately if they experience any of these symptoms. Overall, early recognition and appropriate management of MALA can improve patient outcomes and prevent mortality.