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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)
 
 
 
 
 

Severe hypoglycaemia due to combined use of parenteral nutrition and renal dialysis.

A 24-year-old woman who had sustained serious injuries in a road traffic accident required renal dialysis daily and was fed intravenously with a solution containing 25% dextrose. Subsequently insulin had to be added to the parenteral fluid to maintain blood glucose concentrations at physiological values. On one occasion parenteral feeding was continued until dialysis was started; she became comatose and the plasma glucose concentration was found to be less than 1 mmol/l (18 mg/100 ml). She responded rapidly to a 50 ml intravenous bolus of 50% dextrose. When parenteral feeding and dialysis are used simultaneously glucose passes across the semi-permeable membrane from the blood to the dialysate so that hypoglycaemia may occur. Insulin added to the parenteral fluid further decreases blood glucose concentrations. Stopping parenteral feeding 30-45 minutes before dialysis is started eliminates this danger of hypoglycaemia.[1]

References

  1. Severe hypoglycaemia due to combined use of parenteral nutrition and renal dialysis. Miller, J.D., Broom, J., Smith, G. British medical journal (Clinical research ed.) (1982) [Pubmed]
 
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