Maintenance hemodialysis patient who developed prolonged severe hypoglycemia due to concomitant use of repaglinide and clopidogrel： A case report

Akiyo Inoue; Nobuyuki Takahashi; Kinuko Dote; Kitaro Maruta; Yuichiro Hori; Hiroyasu Tsukaguchi; Kentaro Adachi; Saori Yoshioka; Ayumu Tomoi; Akinori Kitamura; Yoshihiro Taniyama

doi:10.4009/jsdt.59.24

January 1, 2026Nihon Toseki Igakkai ZasshiOpen Access

Maintenance hemodialysis patient who developed prolonged severe hypoglycemia due to concomitant use of repaglinide and clopidogrel： A case report

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Why the study?

Repaglinide is often prescribed in diabetic hemodialysis patients, but clopidogrel-mediated CYP2C8 inhibition is reported to increase repaglinide blood concentrations.

Key Points

Severe hypoglycemia was observed in a hemodialysis patient after initiating clopidogrel.
The patient experienced prolonged low blood sugar ten days post-surgery due to drug interaction with repaglinide.
Assessment relied on clinical observation and patient medication history to identify the interaction risk.
This underscores the need for careful management of drug combinations in patients with renal failure.

Structured PICO

P

Population

1 patient with end-stage renal failure due to diabetic kidney disease on maintenance hemodialysis, managed with repaglinide, who underwent transcatheter aortic valve implantation (TAVI)

I

Intervention

Clopidogrel added for thrombosis prevention post-TAVI while on repaglinide

O

Outcome

Prolonged severe hypoglycemiasafety

Concomitant use of clopidogrel and repaglinide can cause severe, prolonged hypoglycemia in dialysis patients due to CYP2C8 inhibition.

Implication

Avoid clopidogrel-repaglinide coadministration in dialysis patients; hypothesis-generating for CYP2C8 inhibition risks.

Abstract

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Cite This Study

Inoue et al. (2026) studied this question.

synapsesocial.com/papers/69a75b3ec6e9836116a22391 https://doi.org/10.4009/jsdt.59.24

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Maintenance hemodialysis patient who developed prolonged severe hypoglycemia due to concomitant use of repaglinide and clopidogrel： A case report

Key Points

Structured PICO

Implication

Abstract

Discussion

Cite This Study

Maintenance hemodialysis patient who developed prolonged severe hypoglycemia due to concomitant use of repaglinide and clopidogrel： A case report

Key Points

Structured PICO

Implication

Abstract

Discussion

Cite This Study

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