|
비당뇨성 CAPD 환자에서 발생한 고혈당증 및 고삼투압 증후군 |
박민선 , 황승덕 , 문철 , 이희발 |
|
Abstract |
We encountered four episodes of hyperglycemia and hyperosmolar syndrome in 3 out of 366 non-diabetic CAPD patients during perid of 8 years between 1981 and 1989. All 3 patients presented with dyspnea and tremor of head and upper extremities. Peritonitis preceded the onset of symptoms by 2 or 3 weeks in all 3 cases. Two patients who continued CAPD died despite large dose of intraperitoneal (IP) and intravenous (IV) insulin. The remaining one patient survived 2 episodes of hyper- glycemia. In this patient, during the second episode, CAPD was discontinued and hemodialysis commenced immediately after the diagnosis was established. Serum electrolytes and glucose level returned to normal after 2 days of IV normal saline and insulin. CAPD was resumed in about 3 weeks with 6 unit of IP insulin per bag exchange and serum glucose level has remained within normal limits. Heightened awareness and prompt measures include- ing discontinuation of CAPD, insulin administration and correction of ECF volume abnormality will result in a successful management of hypperglycemia and hyper- osmolality in non-diabetic CAPD patients. |
|