| A Case of Sustained Hypoglycemia due to Nateglinide in a Maintenance Hemodialysis Patient |
| Useok Noh, M.D., Joo-Hark Yi, M.D., Eun-Young Kim, M.D., Hyun-Jong Shin, M.D. Jae-Il Park, M.D., Sang-Woong Han, M.D. and Ho-Jung Kim, M.D. |
| Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea |
| 증례 : 유지혈액투석 환자에서 발생한 Nateglinide에 의한 지속 저혈당증 1예 |
| 노유석 이주학 김은영 신현종 박재일 한상웅 김호중 |
| 한양대학교 구리병원 내과 |
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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. |
| Key Words:
Hypoglycemia, Nateglinide, Hemodialysis, End-stage renal disease. |
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