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J Korean Soc Emerg Med > Volume 26(5); 2015 > Article
Journal of The Korean Society of Emergency Medicine 2015;26(5): 480-482.
A Case of Diabetic Ketoacidosis with Refractory Metabolic Acidosis Successfully Treated with Continuous Hemodiafiltration
Seong Hee Lee, Byeong Gwan Kim, A Young Cho, Sang Sun Kim, Hong Shik Shin, Jeong Gwan Kim, In O Sun, Kwang Young Lee, Hyun Ju Yoon
Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
Correspondence  Hyun Ju Yoon ,Tel: 063) 230-1339, Fax: 063) 230-1333, Email: iioo44@naver.com,
Received: May 21, 2015; Revised: May 26, 2015   Accepted: July 7, 2015.  Published online: October 30, 2015.
ABSTRACT
Diabetic ketoacidosis (DKA) is a complex medical disorder characterized by abnormalities in electrolyte, acid-base, and volume status. Metabolic acidosis in mild and moderate DKA is corrected with insulin therapy. Bicarbonate therapy may be indicated in cases of severe metabolic acidosis, however the use of bicarbonate in severe DKA is controversial due to a lack of prospective randomized studies. Renal replacement therapy can be used for correction of systemic acidemia. Continuous renal replacement therapy (CRRT) is used in patients who are too hemodynamically unstable to tolerate conventional hemodialysis, but has also been used in treatment of patients with severe DKA. CRRT has never been used previously in DKA patients with refractory metabolic acidosis in Korea. Here, we describe the successful treatment of a DKA patient with refractory metabolic acidosis with CRRT.
Key words: Diabetic ketoacidosis, Hemodiafiltration, Renal replacement therapy
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