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The Korean Journal of Medicine 1999;57(5): 946-950.
증례 : 혈액투석으로 전환하여 성공적으로 치료한 복막투석치료중인 당뇨병성 만성신부전환자에서 발생한 고삼투압성 혼수 (A case of diabetic hyperosmolar coma treated successfully with conversion to hemodialysis in a chronic renal failure patient on CAPD treatm
고경식, 박경창, 권성희, 이형철, 윤정이, 이준상, 박규용, 구자룡, 김근호, 전로원, 김형직, 채동완, 노정우
Kyung Sik Ko, Kyung Chang Park, Seong Hee Kwon, Hyeong Cheoul Lee, Jeong Yi Yoon, June Sang Lee, Kyu Yong Park, Ja Ryong Koo, Kheun Ho Kim, Rho Won Chun, Dong Wan Chae, Jung Woo Noh,
Continuous ambulatory peritoneal dialysis(CAPD) is now the most important and effective therapeutic modality as well as hemodialysis(HD) and renal transplantation in patients with chronic renal failure. It is frequently recommended to diabetic renal failure patients because of poor, athersclerotic vascularity of them. Hyperglycemia and obesity are not uncommon complications of CAPD therapy. But there were only few reports of very severe hyperglycemia or hyperosmolar coma in CRF patients on CAPD therapy, especially with 7% dextrose CAPD dialysate in foreign countries in the past. Moreover, no specific management for hyperosmolar coma is established in those situations yet. In Korea, only three cases of hyperosmolar coma in non diabetic renal failure patient on CAPD therapy have been reported in one case report. And only one case among them whose CAPD therapy was changed to HD survived. Authors also experienced a case of diabetic hyperosmolar coma treated successfully with conversion to HD in chronic renal failure patient on CAPD therapy. So we report this case with a review of literature. Taken together with this case and review of literature, changing CAPD therapy to HD is regarded to be an important part of treatment when hyperosmolar coma develops in chronic renal failure patients. (Korean. J. Med 57:946-949, 1999)
Keywords: Hyperosmolar coma, Continuous ambulatory peritoneal dialysis(CAPD), Hemo-dialysis(HD)
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