Management of Diabetic Ketoacidosis in a Patient With Chronic Kidney Disease Under Maintenance Hemodialysis: A Case Report.

Autor:	Regmi M; Internal Medicine, Tribhuvan University Institute of Medicine, Kathmandu, NPL., Karki A; Internal Medicine, Tribhuvan University Institute of Medicine, Kathmandu, NPL., Bhandari S; Internal Medicine, Tribhuvan University Institute of Medicine, Kathmandu, NPL., Shrestha M; Internal Medicine, Tribhuvan University Institute of Medicine, Kathmandu, NPL., Kafle P; Critical Care Medicine, Tribhuvan University Institute of Medicine, Kathmandu, NPL.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Jul 30; Vol. 15 (7), pp. e42700. Date of Electronic Publication: 2023 Jul 30 (Print Publication: 2023).
DOI:	10.7759/cureus.42700
Abstrakt:	Diabetic ketoacidosis (DKA) is a potentially fatal metabolic complication seen in individuals with type 1 diabetes mellitus (DM) or type 2 DM under stress, such as infections and non-compliance with treatment. DKA in chronic kidney disease (CKD) patients undergoing maintenance hemodialysis (HD) presents challenges due to the unique pathophysiology and the absence of specific management guidelines. This case report highlights the importance of tailoring the treatment of DKA based on the specific requirements of CKD patients on HD. The presented case involves a 47-year-old female with type 2 DM and CKD who developed DKA in the context of a urinary tract infection (UTI). Management included insulin infusion, cautious fluid replacement therapy, electrolyte monitoring, and identifying precipitating factors, such as an infection. The case highlights the complexity of DKA management in CKD patients and the necessity of individualized approaches. More studies and guidelines are needed to optimize the proper management of DKA in CKD patients. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Regmi et al.)
Databáze:	MEDLINE
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