Critical Care and Shock

Nucleoside analog reverse transcriptase inhibitor induced lactic acidosis treated with continuous renal replacement in the medical intensive care unit



Lactic acidosis due to nucleoside analog reverse transcriptase inhibitors is a known complication of highly active antiretroviral therapy. This possible complication is not widely known to intensivist, and as such there are no definite treatment modalities. The current standard of care is a bicarbonate drip and discontinuing the offending medications. Herein is presented a case of a 40-year-old African American female who developed lactic acidosis due to her HIV medications and was successfully treated with continuous renal replacement therapy (CRRT) as well as the standard of care. In conclusion, CRRT may be a viable treatment option in a patient with nucleoside analog reverse transcriptase inhibitor lactic acidosis.