Electrolyte Blood Press.  2008 Jun;6(1):56-59. 10.5049/EBP.2008.6.1.56.

Recurrent Symptomatic Hyperglycemia on Maintenance Hemodialysis is not Necessarily Related to Hypertonicity: A Case Report

• Park JI
• Yi JH
• Han SW
• Kim HJ

• KMID: 2052307
• DOI: http://doi.org/10.5049/EBP.2008.6.1.56

Abstract

On view of the absent or minimal osmotic diuresis in end stage renal disease, hyperglycemia on maintenance hemolysis as compared to nonketotic hyperosmolar status without underlying advanced renal failure has been noted to show a wide clinical spectrum form severe manifestations by hypertonicity to no clinical manifestations at all. We experienced a 60-year-old man with a known history of type 2 diabetes mellitus on maintenance hemodialysis for 2 years, who was admitted 4 times within 1 year with hyperglycemia (>500 mg/dL) accompanied by recurrent nausea and vomiting at each admission. However, the calculated effective osmolality (tonicity) in this case ranged only from 286 to 303 mOsm/kg H2O. During the past 6 months following meticulous education for the importance of compliance to medication, especially prokinetics for diabetic gastroparesis, he developed no further episode of hyperglycemia or nausea and vomiting.

MeSH Terms

Compliance
Diabetes Mellitus, Type 2
Diuresis
Gastroparesis
Hemolysis
Humans
Hyperglycemia
Kidney Failure, Chronic
Middle Aged
Nausea
Osmolar Concentration
Renal Dialysis
Renal Insufficiency
Vomiting

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