血液透析後に低血糖発作をきたした末期腎不全の1例

Abstract

A 47-year-old man with terminal renal failure secondary to chronic glomerulonephritis was started on hemodialysis with the use of twin coil kidney. The glucose concentration of the dialysis bath was 2000 mg/100ml. One hour after the termination of dialysis the patient became weak, sweaty and confused with generalized seizures, at which time the blood glucose concentration was 40 mg/100ml. Twenty milliliters of 20% glucose was given, with prompt cessation of seizures and return to consciousness. The patient had three proved episodes of hypoglycemia, which occurred within 60 minutes of the termination of dialysis. Four previously reported cases were briefly reviewed. Yet, clear cause of hypoglycemia after dialysis is not known, however, we consider that hypoglycemia should be added to the differential diagnosis of confusional states associated with hemodialysis, because of similarity of the clinical findings of hypoglycemia to those of dialysis disequilibrium syndrome.