J Korean Soc Emerg Med.  2015 Oct;26(5):480-482. 10.0000/jksem.2015.26.5.480.

A Case of Diabetic Ketoacidosis with Refractory Metabolic Acidosis Successfully Treated with Continuous Hemodiafiltration

• Lee SH
• Kim BG
• Cho AY
• Kim SS
• Shin HS
• Kim JG
• Sun IO
• Lee KY
• Yoon HJ

• KMID: 2191711
• DOI: http://doi.org/10.0000/jksem.2015.26.5.480

Abstract

Diabetic ketoacidosis (DKA) is a complex medical disorder characterized by abnormalities in electrolyte, acid-base, and volume status. Metabolic acidosis in mild and moderate DKA is corrected with insulin therapy. Bicarbonate therapy may be indicated in cases of severe metabolic acidosis, however the use of bicarbonate in severe DKA is controversial due to a lack of prospective randomized studies. Renal replacement therapy can be used for correction of systemic acidemia. Continuous renal replacement therapy (CRRT) is used in patients who are too hemodynamically unstable to tolerate conventional hemodialysis, but has also been used in treatment of patients with severe DKA. CRRT has never been used previously in DKA patients with refractory metabolic acidosis in Korea. Here, we describe the successful treatment of a DKA patient with refractory metabolic acidosis with CRRT.

Keyword

Diabetic ketoacidosis; Hemodiafiltration; Renal replacement therapy

MeSH Terms

Acidosis*
Diabetic Ketoacidosis*
Hemodiafiltration*
Humans
Insulin
Korea
Prospective Studies
Renal Dialysis
Renal Replacement Therapy
Insulin