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Published on: June 11, 2012
Recalcitrant hypoglycemia resolved with 2.5% dextrose containing replacement fluid during hemodiafiltration
Tibor Fülöp1, Benahili U Iboaya, Ramachandram Avusula
1Department of Internal Medicine, Division of Nephrology, University of Mississippi Health Care and University of Mississippi Medical Center, Jackson, MS 39216, USA. tfulop@umc.edu
Abstract:
A 52-year-old African American male was admitted with acute kidney injury (AKI) four days after renal cryotherapy. He was started on continuous veno-venous hemodiafiltration (CVVHDF) immediately but his subsequent course was complicated by recurrent hypoglycemia, poorly responding to conventional therapy. To address the recalcitrant hypoglycemia, we changed the replacement fluid to 5% dextrose in water with 150 mEq/L of sodium bicarbonate, Y-connected with 0.9% sodium chloride at a global rate of 2000 mL/hr, with resolution of refractory hypoglycemia. A modified CVVHDF employing hyperglycemic solution can be a valuable addition in treatment of AKI complicated by severe refractory hypoglycemia.
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