Spontaneous hypoglycemia associated with chronic renal failure--a preventable life-threatening complication

Hypoglycemia has been reported in three non-diabetic uremic patients undergoing maintenance hemodialysis. There were one female and two males, ranging in age from 26 to 45 years. Only one hypoglycemic episode per patient was documented, and measured blood glucose levels were less than 1.1 mmol/L. Contributing factors of hypoglycemia in CRF patients were hepatic dysfunction, and drug side effects (isoniazid, rifampin and propranolol). The treatment of choice was intravenous hypertonic glucose administration. Proper nutrition, the judicious use of any medication that has the potential for inducing hypoglycemia, the early detection and treatment of associated diseases, and the use of dialysate fluid with glucose in hemodialysis patients can diminish the risks of this potentially lethal complication.