Continuous renal replacement therapy-the new treatment of seriously hyperglycemia
Continuous renal replacement therapy-the new treatment of seriously hyperglycemia
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DOI：
10.1016/j.ajem.2016.06.061
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发表时间：
2016-12-01
影响因子：
3.6
通讯作者：
Chen, Yanmei
中科院分区：
文献类型：
--
作者：
Tang, Qian;Li, Zhiyong;Chen, Yanmei
糖尿病酮症酸中毒（DKA）和高渗性高血糖综合征（HHS）是糖尿病的急性和潜在危及生命的并发症，通常是突发疾病或不依从治疗的结果。本研究旨在报告1例DKA并发HHS的成功病例，血糖水平高达1969 mg/dL，采用连续性肾脏替代治疗（CRRT）进行治疗，并提供医学文献综述。回顾1例2型糖尿病合并不明原因DKA并发HHS受试者的临床和住院病历。对2000年至2016年发表的相关医学文献进行了电子MEDLINE检索。此外，还审查了相关出版物中已识别文章和其他来源（如教科书章节和会议摘要）的参考文献列表。迄今为止，尚未报告血糖水平高达1881 mg/dL并接受CRRT治疗DKA和HHS引起的急性肾损伤的严重疾病患者。该病例为不能仅使用甘精胰岛素治疗的极高血糖患者提供了DKA或HHS治疗的新方法。总之，CRRT不仅可用于治疗糖尿病肾病，还可用于治疗DKA或HHS以降低血糖。
Diabetic ketoacidosis (DKA) and hypertonic hyperglycemia syndrome (HHS), acute and potentially life-threatening complications of diabetes mellitus, are frequently the result of a precipitating illness or nonadherence to treatment. This study aimed to report one successful case of DKA cocurrent HHS, with blood glucose level reaching up to 1969 mg/dL, treated with continuous renal replacement therapy (CRRT), and to provide a review of the medical literature. The clinic and hospital medical records of 1 subject with type 2 diabetes mellitus and unexplained DKA cocurrent HHS are reviewed. An electronic MEDLINE search of relevant medical literature published from 2000 to 2016 was performed. In addition, the reference lists of the identified articles and other sources, such as textbook chapters and meeting abstracts, were reviewed for related publications. To date, there have been no reports on patients with serious condition whose blood glucose level was up to 1881 mg/dL and who underwent CRRT treatment of acute kidney injury caused by DKA and HHS. The case provides a new method for DKA or HHS treatment for patients who have very high level of blood glucose that cannot only use insulin glargine treatment. In conclusion, CRRT can be used not only to treat diabetic nephropathy but also to treat DKA or HHS to reduce blood glucose.