A case of chronic renal failure with hypoglycemia during hemodialysis (HD)

We report on a case of hypoglycemic coma during HD. A 68-year-old male with a 1.4 year history of maintenace HD reguired for hypertensive nephrosclerosis developed a hypoglycemic coma during HD using bicarbonateglucose free dialysate. Further examinations suggested that malnutrition and its associated conditions such as a low intake of glucose, poor glycogenesis due to decreased hepatic glycogen storage, and poor glyconeogenesis due to decreased alanin may have been responsible for the dialysis-induced hypoglycemia. Our case suggests that those patients with poor nutrition should avoid fasting during HD.