Abstract
Normally the kidneys respond to an acid load by increased ammonia production. In six patients with adult-type diabetes this response was reduced by a mean 50% after a therapeutic dose of phenformin. The reduced ability to compensate for acid loads may be one factor leading to metabolic acidosis and lactoacidosis sometimes associated with phenformin therapy.
Full text
PDF

Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Alleyne G. A., Besterman H. S., Flores H. The effect of phenyl ethyl biguanide in vivo and in vitro on gluconeogenesis and ammonia production in rats. Clin Sci. 1971 Feb;40(2):107–115. doi: 10.1042/cs0400107. [DOI] [PubMed] [Google Scholar]
- Alleyne G. A., Scullard G. H. Renal metabolic response to acid base changes. I. Enzymatic control of ammoniagenesis in the rat. J Clin Invest. 1969 Feb;48(2):364–370. doi: 10.1172/JCI105993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bengtsson K., Karlberg B., Lindgren S. Lactic acidosis in phenformin-treated diabetics. A clinical and laboratory study. Acta Med Scand. 1972 Mar;191(3):203–208. [PubMed] [Google Scholar]
- Gordon E. E., De Hartog M. Gluconeogenesis in renal cortical tubules. Effect of phenformin. Diabetes. 1973 Jan;22(1):50–57. doi: 10.2337/diab.22.1.50. [DOI] [PubMed] [Google Scholar]
- Searle G. L., Schilling S., Porte D., Barbaccia J., De Grazia J., Cavalieri R. R. Body glucose kinetics in nondiabetic human subjects after phenethylbiguanide. Diabetes. 1966 Mar;15(3):173–178. doi: 10.2337/diab.15.3.173. [DOI] [PubMed] [Google Scholar]
- TRANQUADA R. E., BERNSTEIN S., MARTIN H. E. Irreversible lactic acidosis associated with phenformine therapy. Report of three cases. JAMA. 1963 Apr 6;184:37–42. doi: 10.1001/jama.1963.03700140093013. [DOI] [PubMed] [Google Scholar]
- WRONG O., DAVIES H. E. The excretion of acid in renal disease. Q J Med. 1959 Apr;28(110):259–313. [PubMed] [Google Scholar]
