Korean J Nephrol.  2007 Nov;26(6):797-800.

A Case of Sustained Hypoglycemia due to Nateglinide in a Maintenance Hemodialysis Patient

• Noh U
• Yi JH
• Kim EY
• Shin HJ
• Park JI
• Han SW
• Kim HJ

Abstract

The risk of development of hypoglycemia increases during glycemic control in end-stage renal disease (ESRD) patients. We report the case that an ESRD patient on maintenance hemodialysis has experienced sustained hypoglycemia with a nateglinide. A 73-year old male ESRD patient on hemodialysis was admitted with exertional dyspnea and increased liver function test. On the 4th day after admission, he had mental change with his blood glucose level of 41 mg/dL. His mental state improved promptly after intravenous injection of 25 g of glucose. To prevent rebound hypoglycemia 10% glucose solution was continuously infused and nateglinide was discarded. However, he has had recurrent hypoglycemic attacks until the 6th day after admission, and thereafter there was no further hypoglycemic attack. On the 5th day of admission, when there was second hypoglycemic attack, the fasting insulin level was 31.62 U/mL, indicating that hypoglycemia was accompanied by insulin hypersecretion. In conclusion, we suggest that nateglinide may provoke a severe and sustained hypoglycemia in an ESRD patient on maintenance hemodialysis and its use might be avoided.

Keyword

Hypoglycemia; Nateglinide; Hemodialysis; End-stage renal disease

MeSH Terms

Aged
Blood Glucose
Dyspnea
Fasting
Glucose
Humans
Hypoglycemia*
Injections, Intravenous
Insulin
Kidney Failure, Chronic
Liver Function Tests
Male
Renal Dialysis*
Blood Glucose
Glucose
Insulin