Korean J Med.  1999 Nov;57(5):946-949.

A case of diabetic hyperosmolar coma treated successfully with conversion to hemodialysis in a chronic renal failure patient on CAPD treatment

• Lee HC
• Chae DW
• Noh JW
• Koo JR
• Chun RW
• Ko KS
• Park KC
• Kwon SH
• Yoon JY
• Lee JS
• Park KY
• Kim KH

Abstract

Continuous ambulatory peritoneal dialysis(CAPD) is now the most important and effective therapeutic modality as well as hemodialysis(HD) and renal transplantation in patients with chronic renal failure. It is frequently recommended to diabetic renal failure patients because of poor, athersclerotic vascularity of them. Hyperglycemia and obesity are not uncommon complications of CAPD therapy. But there were only few reports of very severe hyperglycemia or hyperosmolar coma in CRF patients on CAPD therapy, especially with 7% dextrose CAPD dialysate in foreign countries in the past. Moreover, no specific management for hyperosmolar coma is established in those situations yet. In Korea, only three cases of hyperosmolar coma in non diabetic renal failure patient on CAPD therapy have been reported in one case report. And only one case among them whose CAPD therapy was changed to HD survived. Authors also experienced a case of diabetic hyperosmolar coma treated successfully with conversion to HD in chronic renal failure patient on CAPD therapy. So we report this case with a review of literature. Taken together with this case and review of literature, changing CAPD therapy to HD is regarded to be an important part of treatment when hyperosmolar coma develops in chronic renal failure patients.

Keyword

Hyperosmolar coma; Continuous ambulatory peritoneal dialysis(CAPD); Hemodialysis(HD)

MeSH Terms

Coma*
Glucose
Humans
Hyperglycemia
Kidney Failure, Chronic*
Kidney Transplantation
Korea
Obesity
Peritoneal Dialysis, Continuous Ambulatory*
Renal Dialysis*
Renal Insufficiency
Glucose