Angioi A, et al. - Researchers reported the outcomes of 28 patients treated with sustained low-efficiency dialysis (SLED) for metformin associated lactic acidosis (MALA) at their center. Until normalization of serum lactate ( ≤3 mmol/L), bicarbonate (between 20 and 25 mmol/L) and potassium (between 4.0 and 5.1 mmol/L), all patients with MALA and acute kidney failure were treated with SLED. Treatment with SLED provided an improved mortality rate in this patient population as compared with other series published in literature. In order to achieve improved outcomes, rapid introduction of effective hemodialysis was considered critical.