Hyperglycemia and Hyperosmolality Complicating Peritoneal Dialysis

Article1 September 1967Hyperglycemia and Hyperosmolality Complicating Peritoneal DialysisJAMES BOYER, M.D., GORDON N. GILL, M.D., FRANKLIN H. EPSTEIN, M.D.JAMES BOYER, M.D., GORDON N. GILL, M.D., FRANKLIN H. EPSTEIN, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-67-3-568 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptHyperglycemia without ketosis may cause coma, convulsions, shock, and death (1-7). Severe disturbances in brain function are a consequence of the high concentration of glucose in the extracellular fluids resulting in intracellular dehydration.Hypertonic glucose solutions are frequently used in peritoneal dialysis to remove edema. High levels of blood glucose have been observed during peritoneal dialysis (8-11), and large amounts of glucose are absorbed (9, 12). The tendency for serum sodium to be elevated after peritoneal dialysis with glucose solutions has also been commented on (10, 11, 13), but the explanation of this phenomenon is not widely appreciated.A patient...References1. POTTER DJ: Death as a result of hyperglycemia without ketosis—a complication of hemodialysis. Ann. Intern. Med. 64: 399, 1966. LinkGoogle Scholar2. SAMANTSCHWARTZ SMB: Severe diabetic stupor without ketosis. S. Afr. Med. J. 31: 893, 1957. MedlineGoogle Scholar3. DANOWSKINABARRO TSJD: Hyperosmolar and other types of nonketoacidotic coma in diabetes. Diabetes 14: 162, 1965. CrossrefMedlineGoogle Scholar4. HALMOSNELSONLOWRY PBJKRC: Hyperosmolar non-ketoacidotic coma in diabetes. Lancet 1: 675, 1966. CrossrefMedlineGoogle Scholar5. DIBENEDETTOCROCCOSOSCIA RJJAJL: Hyperglycemic nonketotic coma. Arch. Intern. Med. (Chicago) 116: 74, 1965. CrossrefMedlineGoogle Scholar6. MACCARIOMESSISVASTOLA MCPEF: Focal seizures as a manifestation of hyperglycemia without ketoacidosis. A report of seven cases with review of the literature. Neurology (Minneap.) 15: 195, 1965. CrossrefMedlineGoogle Scholar7. SCHWARTZAPFELBAUM TBR: Non-ketotic diabetic coma, in The Year Book of Endocrinology, 1965-66 series. Year Book Medical Publishers, Inc., Chicago, p. 165. Google Scholar8. HUTCHINGSHEGSTROMSCRIBNER RHRMBH: Glucose intolerance in patients with long-term intermittent dialysis. Ann. Intern. Med. 65: 275, 1966. LinkGoogle Scholar9. BOEN ST: Kinetics of peritoneal dialysis: a comparison with the artificial kidney. Medicine (Balt.) 40: 243, 1961. CrossrefGoogle Scholar10. MAHERSCHREINER JFGE: Hazards and complications of dialysis. New Eng. J. Med. 273: 370, 1965. CrossrefMedlineGoogle Scholar11. RIBOTJACOBSFRANKELBERNSTEIN SMGHJA: Complications of peritoneal dialysis. Amer. J. Med. Sci. 252: 505, 1966. CrossrefMedlineGoogle Scholar12. DOOLANMURPHEYWIGGENSCARTERCOOPERWATTERNALPEN PDWPRANWWCRHEL: An evaluation of intermittent peritoneal lavage. Amer. J. Med. 26: 831, 1959. CrossrefMedlineGoogle Scholar13. SEGARGIBSONRHAMY WERKR: Peritoneal dialysis in infants and small children. Pediatrics 27: 603, 1961. MedlineGoogle Scholar14. MYERSBAILEY VCCV: The Lewis and Benedict method for the estimation of blood sugar with some observations obtained in disease. J. Biol. Chem. 24: 147, 1916. CrossrefGoogle Scholar15. LINDERHILLERVAN SLYKE GCADD: Carbohydrate metabolism in nephritis. J. Clin. Invest. 1: 247, 1925. CrossrefMedlineGoogle Scholar16. PERKOFFTHOMASNEWTONSELLMANTYLER GTCLJDJCFH: Mechanism of impaired glucose intolerance in uremia and experimental hyperazotemia. Diabetes 7: 375, 1958. CrossrefMedlineGoogle Scholar17. COHEN BD: Abnormal carbohydrate metabolism in renal disease. Blood glucose unresponsiveness to hypoglycemia, epinephrine, and glucagon. Ann. Intern. Med. 57: 204, 1962. LinkGoogle Scholar18. COHENSPRITZRUBINLUCKEY BDNALEH: Hyperguanidemia and hypoglycemic unresponsiveness in renal disease (abstract). Ann. Intern. Med. 54: 1062, 1961. LinkGoogle Scholar19. WESTERVELTSCHREINER FBGE: The carbohydrate intolerance of uremic patients. Ann. Intern. Med. 57: 266, 1962. LinkGoogle Scholar20. HAMPERSSOELDNERDOAKMERRILL CLJSPBJP: Effect of chronic renal failure and hemodialysis on carbohydrate metabolism. J. Clin. Invest. 45: 1719, 1966. CrossrefMedlineGoogle Scholar21. ADOLPH EF: Physiological Regulations. Jacques Cattell Press, Lancaster, Pa., 1943, p. 332. Google Scholar22. PETERS JP: Diabetic acidosis. Metabolism 1: 223, 1952. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JAMES BOYER, M.D.; GORDON N. GILL, M.D.; FRANKLIN H. EPSTEIN, M.D.Affiliations: New Haven, ConnecticutFrom the Department of Medicine, Yale University School of Medicine, New Haven, Conn.This study was supported in part by training grant AM 5015, National Institute of Arthritis and Metabolic Diseases, National Institutes of Health, Bethesda, Md.Dr. Gill was a Training Fellow in Metabolism, Department of Medicine, Yale University School of Medicine. Dr. Epstein was the recipient of career research award 1-K6-AM-21, 578, U. S. Public Health Service, Washington, D. C.Requests for reprints should be addressed to Franklin H. Epstein, M.D., Department of Internal Medicine, Yale University School of Medicine, 333 Cedar St., New Haven, Conn. 06510. 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RAJA, M.D., MARK S. KRAMER, M.D., RAMESH MANCHANDA, M.D., NESTOR LAZARO, M.D., JERRY L. ROSENBAUM, M.D., F.A.C.P.KETOTIC HYPEROSMOLAR COMADietary treatment of renal failurePotassium removal with peritoneal dialysisGlucose Absorption and Hyperglycaemia During Peritoneal DialysisHyperosmolar Non-Ketotic Coma in a Kidney Transplant RecipientDIETARY MANAGEMENT IN RENAL FAILUREFluid and Electrolyte Complications of Peritoneal Dialysis Choice of Dialysis SolutionsM. HENRY GAULT, M.D., F.A.C.P., E. L. FERGUSON, M.D., J. S. SIDHU, M.D., R. P. CORBIN, M.D.Hyperosmolar nonketotic coma with hyperglycemia: Abnormalities of lipid and carbohydrate metabolismEinflu� der Osmolarit�t in der Sp�lfl�ssigkeit auf die Effektivit�t der PeritonealdialyseGlucose Absorption from the Dialysis Fluid During Peritoneal DialysisHyperosmotic Coma Complicating Peritoneal Dialysis with Sorbitol DialysateRASIB M. RAJA, M.D., JULIO G. MOROS, M.D., MARK S. KRAMER, M.D., JERRY L. ROSENBAUM, M.D., F.A.C.P.Hyperosmolar non-ketoacidotic coma as a complication of cerebral compression.The surgical significance of hyperosmolar comaHyperosmolality in LeptospirosisPeritoneal DialysisClinical pathologic conferencePeritoneal Sodium Transport During Hypertonic Peritoneal Dialysis Physiologic Mechanisms and Clinical ImplicationsKARL D. NOLPH, JESSIE E. HANO, PAUL E. TESCHANResponse of serum Mg and K to glucose and insulin infusion in uremic dogsTHE USE OF DEXTRAN AS A DIALYSING FLUID IN PERITONEAL DIALYSISDialysis-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. 1 September 1967Volume 67, Issue 3_Part_1Page: 568-572KeywordsCareers in researchConvulsionsEdemaGlucoseHyperglycemiaMedical servicesMetabolic disordersPeritoneal dialysisShockSodium ePublished: 1 December 2008 Issue Published: 1 September 1967 PDF downloadLoading ...