A Case of Sustained Hypoglycemia due to Nateglinide in a Maintenance Hemodialysis Patient.
- Author:
Useok NOH
1
;
Joo Hark YI
;
Eun Young KIM
;
Hyun Jong SHIN
;
Jae Il PARK
;
Sang Woong HAN
;
Ho Jung KIM
Author Information
1. Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea. cardion@hanyang.ac.kr
- Publication Type:Case Report
- Keywords:
Hypoglycemia;
Nateglinide;
Hemodialysis;
End-stage renal disease
- MeSH:
Aged;
Blood Glucose;
Dyspnea;
Fasting;
Glucose;
Humans;
Hypoglycemia*;
Injections, Intravenous;
Insulin;
Kidney Failure, Chronic;
Liver Function Tests;
Male;
Renal Dialysis*
- From:Korean Journal of Nephrology
2007;26(6):797-800
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
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.
