Peritoneal dialysis in the treatment of acetohexamide-induced hypoglycemia

Severe hypoglycemia in a 67-year-old black male as a result of the ingestion of acetohexamide is described. Because of both his renal status as well as the severity of the hypoglycemia, the patient received peritoneal dialysis. Sequential specimens of serum, urine and dialysate were collected to measure the levels of acetohexamide and its main active metabolite, hydroxyhexamide. The data indicate that these compounds are not dialyzable. In patients with reduced renal function, peritoneal dialysis may be one way to administer large amounts of glucose with very little administration of fluid in the treatment of acetohexamide-induced hypoglycemia. For those azotemic patients whose hypoglycemia is difficult to manage, intensive dialysis might be a means to correct the abnormality of glucose metabolism imposed by uremia.