Skoutakis V A, Black W D, Acchiardo S R, Wood G C
Am J Hosp Pharm. 1977 Jan;34(1):68-70.
Severe hypoglycemia in a 67-year-old black male as a result of the ingestion of acetohexamide is described. Because of both his renal status as well as the severity of the hypoglycemia, the patient received peritoneal dialysis. Sequential specimens of serum, urine and dialysate were collected to measure the levels of acetohexamide and its main active metabolite, hydroxyhexamide. The data indicate that these compounds are not dialyzable. In patients with reduced renal function, peritoneal dialysis may be one way to administer large amounts of glucose with very little administration of fluid in the treatment of acetohexamide-induced hypoglycemia. For those azotemic patients whose hypoglycemia is difficult to manage, intensive dialysis might be a means to correct the abnormality of glucose metabolism imposed by uremia.
描述了一名67岁黑人男性因摄入醋磺己脲而发生严重低血糖的病例。鉴于其肾脏状况以及低血糖的严重程度，该患者接受了腹膜透析。收集了血清、尿液和透析液的连续样本，以测量醋磺己脲及其主要活性代谢物羟基己脲的水平。数据表明这些化合物不可透析。对于肾功能减退的患者，腹膜透析可能是在治疗醋磺己脲引起的低血糖时大量输注葡萄糖且极少输注液体的一种方法。对于那些低血糖难以控制的氮质血症患者，强化透析可能是纠正尿毒症所致葡萄糖代谢异常的一种手段。
