증례 : 비당뇨성 말기신부전환자에서 복막투석 중 발생한 고혈당증 및 고삼투압증후군 1 예

In non-diabetic end-stage renal disease patients, blood glucose concentrations have not significantly changed over time on CAPD. But hypergycemia and hyperosmolality may develop with the use of hypertonic dextrose solutions for peritoneal dialysis. Hyperglycemia without ketosis can cause coma, convulsions, shock, or death. Severe disturbances in brain function are a consequence of the high collection of glucose in the extracellular fluids resulting in intracellular dehydration. A 54-year-old male, non-diabetic end-stage renal disease patient, who had been taken CAPD for 16 months, was hospitalized because of drowsy mental state. He used 4.25% glucose solution for peritoneal dialysis 3 times in a day because of edema. He revealed hyperglycemia and hyperosmolality. Serum glucose level and osmolality returned to normal after injection of normal saline and insulin.