ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2023 and some content may be unavailable. To unlock all content for 2023, please visit the archives.

Abstract: FR-PO264

Type B Lactic Acidosis Secondary to Metastatic Liver Cancer in the Setting of Normal Renal Function: A Case Report

Session Information

Category: Onconephrology

  • 1700 Onconephrology


  • Poyser, Tracy-Ann, Unity Health White County Medical Center, Searcy, Arkansas, United States
  • Amakiri, Chidinma P., Unity Health White County Medical Center, Searcy, Arkansas, United States
  • Pham, Steven, Unity Health White County Medical Center, Searcy, Arkansas, United States

Lactic acidosis occurs when lactate levels are greater than 4 mmol/L. It is due to an overproduction of lactate or decreased metabolism. There are two types, Type A and Type B. Type B is more common in hematological conditions, such as multiple myeloma, leukemia, and lymphoma.

Case Description

We present a case of a 43-year-old male with Type B lactic acidosis secondary to stage IV colon cancer with metastasis to the liver. Computed Tomography scan of the abdomen and pelvis showed extensive hepatic metastasis with marked hepatosplenomegaly and mild ascites. He had a lactic acid of 16.5 mmol/L, glucose of 52 mg/dl, and bicarbonate of 8 mEq. He received aggressive fluid resuscitation, IV antibiotics, and bicarbonate supplementation. However, his lactic acid worsened, requiring urgent dialysis. Despite dialysis, he showed no significant improvement, and was placed on hospice.


Type B lactic acidosis can arise as a complication of solid and, more commonly, hematological malignancies, such as multiple myeloma, lymphoma, and leukemia. It is a rare complication that requires prompt diagnosis and treatment of the underlying condition. Treatment modalities, such as hemodialysis and chemotherapy, have been studied, but the prognosis remains poor. Our patient with type B lactic acidosis received hemodialysis, sodium bicarbonate, and glucose supplementation with marginal initial improvement, followed by worsening lactic acidosis. Due to the late stage of his cancer, chemotherapy was not beneficial. There is a paucity of information due to the rarity of studies on severe lactic acidosis. More studies are needed to better understand the pathogenesis of type B lactic acidosis secondary to hematological malignancies to improve patient outcomes.

Imaging showing extensive liver metastasis with significant hepatosplenomegaly and ascites.