Endocrine research · 2026
Diabetic ketoacidosis and hyperosmolar hyperglycemic state in patients with end-stage renal disease on dialysis: a review.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Aoun Laurence, Itani Hadi, Kaspar Chris, Al Achkar Michel, Saliba Fares, Al Mardini Shaza, Abidor Erica, Aldalahmeh Mohammad, Khamis Zaid, Habib Toni, Haddadin Fadi, Azam Waleed, Dankar Razan, Barakat Salim, Pannala Sai Shanmukha Sreeram, Zaidan Julie
Аннотация
PURPOSE: This review aims to discuss the prevalence, risk factors, and management of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) in patients with end-stage renal disease (ESRD) on hemodialysis.
METHODS: A comprehensive literature review of retrospective studies, case reports, and clinical guidelines was conducted.
RESULTS: DKA and HHS incidence is lower in ESRD patients due to delayed insulin clearance and regular dialysis. Management requires cautious fluid administration, reduced insulin infusion rates, conservative potassium replacement, and gradual correction of hyperosmolarity. Emergency hemodialysis may be necessary for severe acidosis or hyperkalemia.
CONCLUSION: Treatment must be individualized. Emerging strategies, including extended dialysis sessions and closed-loop insulin delivery, require further validation.
METHODS: A comprehensive literature review of retrospective studies, case reports, and clinical guidelines was conducted.
RESULTS: DKA and HHS incidence is lower in ESRD patients due to delayed insulin clearance and regular dialysis. Management requires cautious fluid administration, reduced insulin infusion rates, conservative potassium replacement, and gradual correction of hyperosmolarity. Emergency hemodialysis may be necessary for severe acidosis or hyperkalemia.
CONCLUSION: Treatment must be individualized. Emerging strategies, including extended dialysis sessions and closed-loop insulin delivery, require further validation.