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KMID : 0378019830260030091
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New Medical Journal
1983 Volume.26 No. 3 p.91 ~ p.98
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Experience of Insulin Theraphy mixed in the Dialysate in Two Cases of Diabetics with End-Stage Renal Disease on Chronic Ambulatory Peritoneal Dialysis (C. A. P. D.)
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Abstract
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Two cases of end-stage renal failure complicated with diabetes who require insulin to control their blood sugar were treated with continuous ambulatory peritoneal dialysis (CAPD) at Han Yang University Hospital.
Used dialysates were Peritosol® 150 and 425, and regular insulin was given mixed in the dialysate according to the Toronto Western Hospital Protocol.
The results are as following:
1. Blood sugar was controlled more ideally showing almost normal pre-prandial values by regular insulin mixed in dialysate in both patients.
2. Blood pressure was controlled quite effectively by CAPD and antihypertensive drug was reduced in dosage in one patient and discontinued in another by the end of 7th week of CAPD.
3. Anemia was corrected gradually and both hemoglobin and heamtocrit were increased in both patients during CAPD.
4. Serum electrolytes, potassium and calcium were rapidly corrected and achieved normal value by 4th day of CAPD.
5. Serum BUN and creatinine were suppressed and maintained in reasonable level; BUN being less than 50mg/dl, creatinine being around 5mg/dl.
6. Serum total protein and albumin were increased in spite of considerable loss through the dialysate. This must be due to increased protein intake as patients´ appetite was increased and tolerated well to high protein diet.
7. CAPD was successfully continued over 8 months until present in one patient without any significant complication, but in another CAPD was discontinued 3 months later due to recurrent peritonitis.
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