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KMID : 0354719720010010045
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Journal of Korean Diabetes Association
1972 Volume.1 No. 1 p.45 ~ p.48
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Experience with Hemodialysis in Diabetic Nephrosclerosis
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윤동식/Yoon, D.S.
홍순조/방병기/김동집/민병석/Hong, S.J./Bang, B.K./Kim, D.J./Min, B.S.
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Abstract
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Hemodialysis in the diabetics with renal failure presents a special problem because of the accentuated hyperglycemia and hyperosmolality which may precipitate nonketotic coma.
The authors intend to report their experience with 5 hemodialysises in a 56 year-old Korean male patient with renal failure and massive anasarca due to diabetic glomerulosclerosis. Because of progressive edema and uremic symptoms, hemodialysis was carried out on 5 occasions at weekly interval with different insulin dosages and various amounts of glucose and mannitol added to dialyzing solution. Kolff´s Twin-coil dialyzer was used. Although ´reduction in body weight by as much as 3.8 kg was achieved with 400´gm of glucose added every hour to the dialyzing solution, the blood glucose levels rose to near 300 mg when the patient developed hedache, nausea, vomiting and hypertension.
Satisfactory result was obtained with moderate reduction in body weight (2.5 kg) and with little fluctuations in glucose levels, requiring no additional insulin, when mannitol was added every hour to the dialyzing solution.
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