Hyperglycemia and Hyperosmolality Complicating Peritoneal Dialysis

Publisher Website
Google Scholar
Abstract
A patient with chronic renal insufficiency who developed hyperglycemia (blood sugar 2400 mg%) with coma and convulsions during peritoneal dialysis, is described. Glucose absorption and changes in blood glucose were then measured in this patient and in others undergoing peritoneal dialysis. Five and 3/10 g of glucose were absorbed from each liter of 1.5% dialysate, 21.9 g from each liter of 4.25% dialysate, and 33.3 g from each liter of 7% dialysate. With 3 2 liter exchanges hyperglycemia occurred commonly using 7% solutions, but occurred only occasionally using 4.25% dialysate solutions. Peritoneal dialysis is a unique situation for magnification of the hyperosmolarity resulting from hyperglycemia because the serum Na+ is fixed at that of the peritoneal dialysis fluid. Prolonged use of hypertonic dialysis solutions may result in severe hyperosmolarity.