Death as a Result of Hyperglycemia Without Ketosis—A Complication of Hemodialysis
Authors: DANIEL J. POTTER
Journal: Annals of Internal Medicine (1966)

Brief Communications1 February 1966Death as a Result of Hyperglycemia Without Ketosis—A Complication of HemodialysisDANIEL J. POTTER, M.D.DANIEL J. POTTER, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-2-399 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSevere symptoms of central nervous system dysfunction produced by hyperosmolality of extracellular fluid have been described recently; the common feature in these cases has been hypernatremia with or without hyperglycemia (1-6). This paper reports a death attributable to hyperglycemia produced by hemodialysis with hypertonic glucose. The serum concentration of sodium was normal, and there was no ketosis or acidosis.CASE REPORTPatient C. I., a 39-year-old man with a 14-year history of albuminuria, hypertension and, finally, uremia, was admitted to Good Samaritan Hospital on August 24, 1964. His creatinine clearance was 2.5 ml/min. His blood urea nitrogen (BUN) rose from...References1. ZIERLER K: Hyperosomolality in adults, a critical review. J. Chronic Dis. 7: 1, 1958. CrossrefMedlineGoogle Scholar2. ROSENBERGBRIEFKINNEYHERRERAWILSONMOORE SADKJMMGRERE: Syndrome of dehydration, coma and severe hyperglycemia without ketosis in patients convalescing from burns. New Eng. J. Med. 272: 931, 1965. CrossrefMedlineGoogle Scholar3. MACCARIOMESSISKOSTOLA MCPEF: Focal seizures as a manifestation of hyperglycemia without ketoacidosis. Neurology 15: 195, 1965. CrossrefMedlineGoogle Scholar4. FREEMANMAHERSCHREINER RBJFGE: Hemodialysis for chronic renal failure: I. Technical considerations. Ann. Intern. Med. 62: 519, 1965. LinkGoogle Scholar5. LUCASGRANTDAILEYREAVEN CPNWJGM: Diabetic coma without ketoacidosis. Lancet 1: 75, 1963. CrossrefMedlineGoogle Scholar6. IYENGAR MO: Extreme hyperglycemia without ketosis. Lancet 2: 664, 1961. CrossrefGoogle Scholar7. BARRY K: Personal communication, November, 1964. Google Scholar8. KENNEDYLINTONLUKERENFREWDINWOODIE ACALRGSA: The pathogenesis and prevention of cerebral dysfunction during dialysis. Lancet 1: 790, 1964. CrossrefMedlineGoogle Scholar9. KENNEDYLINTONLUKERENFREW ACALRGS: Electroencephalographic changes during haemodialysis. Lancet 1: 408, 1963. CrossrefMedlineGoogle Scholar10. ROSENO'CONNORSHALDON SMKS: Haemodialysis dysequilibrium. Brit. Med. J. 2: 672, 1964. CrossrefMedlineGoogle Scholar11. HOLMESNAKIMOTO JHS: Removal of fluid from the patient during hemodialysis. Trans. Amer. Soc. Artif. Intern. Organs 5: 58, 1959. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Phoenix, ArizonaFrom the Good Samaritan Hospital, Phoenix, Ariz.Requests for reprints should be addressed to Daniel J. Potter, M.D., 444 W. Osborn Rd., Phoenix, Ariz. 85013. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Corrected Serum Sodium Concentration in Hyperglycemic Crises: Computation and Clinical ApplicationsDialysis-associated hyperglycemia: manifestations and treatmentSerum Sodium Concentration and Tonicity in Hyperglycemic Crises: Major Influences and Treatment ImplicationsAbnormalities of serum potassium concentration in dialysis-associated hyperglycemia and their correction with insulin: review of published reportsGlucose in the dialysateBody fluid abnormalities in severe hyperglycemia in patients on chronic dialysis: review of published reportsSerum Potassium and Acid-base Parameters in Severe Dialysis-associated Hyperglycemia Treated with Insulin TherapySerum Tonicity, Extracellular Volume and Clinical Manifestations in Symptomatic Dialysis-Associated Hyperglycemia Treated Only with InsulinSevere Asymptomatic Hypergl Ycemia in a Nondiabetic Capd PatientHyperosmolar Hyperglycemic Nonketotic ComaDiagnosis and Management of Hypertonicity in Peritoneal DialysisEffect of Hyperglycemia on Serum Sodium Concentration and Tonicity in Outpatients on Chronic DialysisLethal Hyperkalemia Associated With Severe Hyperglycemia in Diabetic Patients With Renal FailureHyperosmolar hyperglycemic nonketotic syndrome'Contraction' Alkalosis during Treatment of Hypergl Ycemia in CAPD PatientsRegular Dialysis Treatment (RDT)Management of Diabetes in the Surgical PatientRegular Dialysis TreatmentA Review of Hypersomolar Hyperglycemic Nonketotic Dehydration (HHND): Etiology, Pathophysiology and Prevention During Intravenous HyperalimentationHyperosmolar Nonketotic Coma in the Elderly DiabeticOsmolality Changes during Hemodialysis Natural History, Clinical Correlations, and Influence of Dialysate Glucose and Intravenous MannitolFRANCISCO RODRIGO, M.D., JEFFREY SHIDEMAN, B.S., RICHARD McHUGH, Ph.D., THEODORE BUSELMEIER, M.D., CARL KJELLSTRAND, M.D., F.A.C.P.The Treatment of End-stage Renal Failure in Insulin-dependent Diabetic PatientsDiabetes und NierenDisequilibrium Syndrome in HemodialysisDeath following non-ketotic hyperglycaemic coma during diazoxide therapy and peritoneal dialysisKETOTIC HYPEROSMOLAR COMADietary treatment of renal failurePrevention of dialysis disequilibrium syndrome by use of high sodium concentration in the dialysateCerebral and pontine myelinolysisHyperosmolar Non-Ketotic Coma in a Kidney Transplant RecipientDIETARY MANAGEMENT IN RENAL FAILURENon-Ketotic Coma and Diabetes MellitusHyperosmolar nonketotic coma with hyperglycemia: Abnormalities of lipid and carbohydrate metabolismRemission in DiabetesPeritoneal Dialysis and HemodialysisThe surgical significance of hyperosmolar comaHyperosmolar Hyperglycemic Nonketotic Diabetic ComaClinical pathologic conferenceHYPEROSMOLAR STATES IN THE CHRONICALLY ILLDialysis-induced hyperglycemic nonketotic comaHyperosmolar non-ketotic diabetic comaHyperglycemic, Hyperosmolar, Nonketotic Coma in a Ketosis-Prone Juvenile DiabeticMYRON LOTZ, M.D., F.A.C.P., MICHAEL GERAGHTY, M.D.REMOVAL OF REFRACTORY ŒDEMA FLUID BY PERITONEAL DIALYSISHypoglycemia — A Complication of HemodialysisHyperglycemia and Hyperosmolality Complicating Peritoneal DialysisJAMES BOYER, M.D., GORDON N. GILL, M.D., FRANKLIN H. EPSTEIN, M.D.Changes in glucose and insulin metabolism induced by dialysis in patients with chronic uremia 1 February 1966Volume 64, Issue 2Page: 399-401KeywordsAttentionBlood urea nitrogenCreatinineGlucoseHyperglycemiaHypernatremiaHypertensionMedical dialysisSodiumUltrafiltration Issue Published: 1 February 1966 PDF downloadLoading ...