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KMID : 0359920070260060797
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Korean Journal of Nephrology
2007 Volume.26 No. 6 p.797 ~ p.800
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A Case of Sustained Hypoglycemia due to Nateglinide in a Maintenance Hemodialysis Patient
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Roh You-Seok
Yi Joo-Hark
Kim Eun-Young
Shin Hyun-Jong
Park Jae-Il
Han Sang-Woong
Kim Ho-Jung
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Abstract
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The risk of development of hypoglycemia increases during glycemic control in end-stage renal disease (ESRD) patients. We report the case that an ESRD patient on maintenance hemodialysis has experienced sustained hypoglycemia with a nateglinide. A 73-year old male ESRD patient on hemodialysis was admitted with exertional dyspnea and increased liver function test. On the 4th day after admission, he had mental change with his blood glucose level of 41 mg/dL. His mental state improved promptly after intravenous injection of 25 g of glucose. To prevent rebound hypoglycemia 10% glucose solution was continuously infused and nateglinide was discarded. However, he has had recurrent hypoglycemic attacks until the 6th day after admission, and thereafter there was no further hypoglycemic attack. On the 5th day of admission, when there was second hypoglycemic attack, the fasting insulin level was 31.62 U/mL, indicating that hypoglycemia was accompanied by insulin hypersecretion. In conclusion, we suggest that nateglinide may provoke a severe and sustained hypoglycemia in an ESRD patient on maintenance hemodialysis and its use might be avoided.
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KEYWORD
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Hypoglycemia, Nateglinide, Hemodialysis, End-stage renal disease
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