A Case of Euglycemic Ketoacidosis Secondary to Continuous Renal Replacement Therapy

Euglycemic ketoacidosis (EKA) has been reported as a rare but life-threatening complication of continuous renal replacement therapy (CRRT). EKA should be suspected in the setting of persistent high anion gap metabolic acidosis despite renal replacement therapy. Critically ill patients, especially th...

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Main Authors: Evan J. Chen, William A. West, Kavitha Bagavathy
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/crcc/6275218
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author Evan J. Chen
William A. West
Kavitha Bagavathy
author_facet Evan J. Chen
William A. West
Kavitha Bagavathy
author_sort Evan J. Chen
collection DOAJ
description Euglycemic ketoacidosis (EKA) has been reported as a rare but life-threatening complication of continuous renal replacement therapy (CRRT). EKA should be suspected in the setting of persistent high anion gap metabolic acidosis despite renal replacement therapy. Critically ill patients, especially those with diabetes mellitus, are at risk of EKA due to deficient caloric intake, the presence of excess counterregulatory stress hormones, and nutritional losses from CRRT. Even with the use of glucose-containing dialysates, EKA can be observed. Prompt treatment with insulin and glucose-containing infusions leads to rapid resolution of the condition. Early optimization of nutritional intake can prevent or mitigate EKA. This case report describes a patient who developed EKA while on CRRT for severe acute kidney injury from neuroleptic malignant syndrome.
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spelling doaj-art-3adb0f87f20441d39664fa5b4e6457902025-01-11T00:00:03ZengWileyCase Reports in Critical Care2090-64392025-01-01202510.1155/crcc/6275218A Case of Euglycemic Ketoacidosis Secondary to Continuous Renal Replacement TherapyEvan J. Chen0William A. West1Kavitha Bagavathy2Department of Pulmonary & Critical Care MedicineDepartment of Pulmonary & Critical Care MedicineDivision of PulmonaryEuglycemic ketoacidosis (EKA) has been reported as a rare but life-threatening complication of continuous renal replacement therapy (CRRT). EKA should be suspected in the setting of persistent high anion gap metabolic acidosis despite renal replacement therapy. Critically ill patients, especially those with diabetes mellitus, are at risk of EKA due to deficient caloric intake, the presence of excess counterregulatory stress hormones, and nutritional losses from CRRT. Even with the use of glucose-containing dialysates, EKA can be observed. Prompt treatment with insulin and glucose-containing infusions leads to rapid resolution of the condition. Early optimization of nutritional intake can prevent or mitigate EKA. This case report describes a patient who developed EKA while on CRRT for severe acute kidney injury from neuroleptic malignant syndrome.http://dx.doi.org/10.1155/crcc/6275218
spellingShingle Evan J. Chen
William A. West
Kavitha Bagavathy
A Case of Euglycemic Ketoacidosis Secondary to Continuous Renal Replacement Therapy
Case Reports in Critical Care
title A Case of Euglycemic Ketoacidosis Secondary to Continuous Renal Replacement Therapy
title_full A Case of Euglycemic Ketoacidosis Secondary to Continuous Renal Replacement Therapy
title_fullStr A Case of Euglycemic Ketoacidosis Secondary to Continuous Renal Replacement Therapy
title_full_unstemmed A Case of Euglycemic Ketoacidosis Secondary to Continuous Renal Replacement Therapy
title_short A Case of Euglycemic Ketoacidosis Secondary to Continuous Renal Replacement Therapy
title_sort case of euglycemic ketoacidosis secondary to continuous renal replacement therapy
url http://dx.doi.org/10.1155/crcc/6275218
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