Masoumeh Asgharpour
1 
, Rouzbeh Danialy
2 , Seyedhadi Mirhashemi
3* , Semko Ebrahimi
5 1 Department of Nephrology, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
2 Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Department of Anesthesiology, Health North gGmbH Klinikverbund Bremen, Hospital left of the Weser (klinkum Links der Weser) (Senator-Weßling-Straße 1; 28277), Bremen, Germany
5 Department of Anesthesiology, Health North gGmbH Klinikverbund Bremen, Hospital left of the Weser (klinkum Links der Weser) (Senator-Weßling-Straße 1; 28277), Bremen, Germany
Abstract
Iodinated contrast agents are routinely used to diagnose a variety of diseases especially malignant
tumors. They are crucial for accurate depiction of tumors, monitoring the response to treatment,
and assessing possible recurrence of malignant lesions. Unfortunately, there are potential adverse
effects associated with their administration. Metformin as an antidiabetic drug is prescribed widely.
The drug is usually administered to control type II diabetes mellitus. One of the most important
side effects of metformin is the possibility of lactate accumulation and occurrence of metforminassociated lactic acidosis (MALA), which develops under various circumstances including decreased
renal function or concurrent use of toxic agents. Since, intravascular injection of iodinated contrast
agents for radiologic purposes may result in kidney injury, it is suggested that metformin should be
held in diabetic patients with renal failure before administration of contrast media and not to be
taken by the patient again till 48 hours after the procedure and assessment of kidney function which
should be normal.
Implication for health policy/practice/research/medical education:
Diabetic individuals with renal failure using metformin are at high risk of metformin-associated lactic acidosis if they are scheduled for
iodinated contrast study.
Please cite this paper as: Asgharpour M, Danialy R, Mirhashemi SH, Mirzazadeh A, Ebrahimi S. Intravenous contrast agents in diabetic
patients taking metformin; an updated review on current concepts. J Nephropathol. 2020;9(1):e05. DOI: 10.15171/jnp.2020.05.