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Recurrent symptomatic hyperglycemia on maintenance hemodialysis is not necessarily related to hypertonicity: A case reportopen access

Authors
Park, Jae-IlYi, Joo-HarkHan, Sang-WoongKim, Ho-Jung
Issue Date
Jun-2008
Publisher
Korean Society of Electrolyte and Blood Pressure Research
Keywords
Hemodialysis; Hyperglycemia; Hyperosmolality
Citation
Electrolyte and Blood Pressure, v.6, no.1, pp.56 - 59
Indexed
SCOPUS
KCI
OTHER
Journal Title
Electrolyte and Blood Pressure
Volume
6
Number
1
Start Page
56
End Page
59
URI
https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/172010
DOI
10.5049/EBP.2008.6.1.56
ISSN
1738-5997
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.
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