Related Experiment Video
Updated: May 3, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Recurrent Symptomatic Hyperglycemia on Maintenance Hemodialysis is not Necessarily Related to Hypertonicity : A Case
Jae-Il Park1, Joo-Hark Yi1, Sang-Woong Han1
1Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.
Abstract:
On view of the absent or minimal osmotic diuresis in end stage renal disease, hyperglycemia on maintenance hemolysis as compared to nonketotic hyperosmolar status without underlying advanced renal failure has been noted to show a wide clinical spectrum form severe manifestations by hypertonicity to no clinical manifestations at all. We experienced a 60-year-old man with a known history of type 2 diabetes mellitus on maintenance hemodialysis for 2 years, who was admitted 4 times within 1 year with hyperglycemia (>500 mg/dL) accompanied by recurrent nausea and vomiting at each admission. However, the calculated effective osmolality (tonicity) in this case ranged only from 286 to 303 mOsm/kg H2O. During the past 6 months following meticulous education for the importance of compliance to medication, especially prokinetics for diabetic gastroparesis, he developed no further episode of hyperglycemia or nausea and vomiting.
Related Concept Videos
Hyperglycemia
Hemodialysis II: Procedure and Complications
Diabetic Nephropathy
Hyperosmolar Hyperglycemic State
Hypoglycemia and Glucagon
Complications of Diabetes Mellitus

