Korean J Nephrol.  2001 May;20(3):515-519.

Two Cases of Diabetic Hyperglycemic Hyperosmolar Coma Treated with Maintaining CAPD in Chronic Renal Failure Patients with CAPD

• Kang HJ
• Park CW
• Lee SY
• Choi HC
• Lee JR
• Son JM
• Shin YS
• Chang YS
• Bang BK

Abstract

We reported two cases of diabetic hyperglycemic hyperosmolar coma treated with maintaining continuous ambulatory peritoneal dialysis(CAPD) in chronic renal failure(CRF) patients with CAPD. Hyperglycemia is common complication in CAPD, but there were only few reports of severe hyperglycemia accompanying with hyperosmolar coma in CRF patients on CAPD therapy. Furthermore, to date, no specific management for CAPD patients with nonketotic hyperosmolar coma has been established. The best strategy for management of hyperosmolar coma with CAPD patients is changing CAPD therapy to HD. Recently, we experienced two cases of hyperglycemic hyperosmolar coma in diabetic CAPD patients successfully treated with intravenous hydration and insulin therapy without discontinuing CAPD therapy. Because no such case has been reported, we report two cases of diabetic hyperosmolar coma with CAPD treated without conversion to HD. These cases suggest that adequate fluid replacement accompanying electrolytes and osmotic balance as well as insulin therapy might be a major role for safe treatment of hyperglycemic hyperosmolar coma in patient with CAPD.

Keyword

Hyperglycemic hyperosmolar coma; Continuous ambulatory peritoneal dialysis; Hemodialysis

MeSH Terms

Coma*
Electrolytes
Humans
Hyperglycemia
Insulin
Kidney Failure, Chronic*
Peritoneal Dialysis, Continuous Ambulatory*
Renal Dialysis
Electrolytes
Insulin