The Experts below are selected from a list of 39 Experts worldwide ranked by ideXlab platform
K Hamaguchi - One of the best experts on this subject based on the ideXlab platform.
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Rhabdomyolysis related-acute renal failure in a patient with hyperosmolar Nonketotic Diabetic Coma (HNKC): demonstration of myoglobin casts after normalization of renal function
Nihon Jinzo Gakkai shi, 1996Co-Authors: A Nakazawa, A Ohishi, M Nakamura, K Kaneko, N Aosaki, H Sugiura, Y Miyoshi, K HamaguchiAbstract:We report a patient with rhabdomyolysis secondary to hyperosmolar Nonketotic Diabetic Coma (HNKC), who progressed to acute renal failure. A 43-year-old male with diabetes mellitus for three years was admitted to our hospital because of loss of consciousness. The laboratory findings at admission were as follows: serum glucose 1792 mg/dl, serum Na 129 mEq/1, BUN 71 mg/d1, serum creatinine 3.3 mg/d1, CPK 715 IU/1, plasma osmolality 370 mOsm/1, and negative urine ketone bodies. A diagnosis of HNKC was made. On the 2nd day, he had oliguria and the serum creatinine increased despite adequate treatment of HNKC by the administration of intravenous fluid and insulin. On the 4th day, CPK reached 47,300 IU/1, and serum myoglobin was also increased, indicating rhabdomyolysis. His renal function improved gradually and was almost normalized on the 20th day. Renal biopsy on the 23rd day showed myoglobin at the distal renal tubules, which appeared to be involved in the pathogenesis of renal failure by rhabdomyolysis. However, we found little abnormality association with Diabetic nephropathy in the renal tissue. Since HNKC is known to induce acute renal failure rarely without Diabetic nephropathy, these findings suggested that the acute renal failure was caused mainly by the rhabdomyolysis. Acute renal failure induced by rhabdomyolysis in patients with HNKC is rare, but fatal. The present study showed that the measurement of serum CPK and urine myoglobin was helpful for early diagnosis. Only 12 cases have been reported to have developed renal failure due to rhabdomyolysis among patients with HNKC. To our knowledge, we demonstrated for the first time that myoglobin at the distal renal tubules after renal function was normalized.
Meng Bang-zhu - One of the best experts on this subject based on the ideXlab platform.
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Experience of Rescue 12 Cases of Hyperosmolar Nonketotic Diabetic Coma by Digestive Fluid Infusion
Journal of Inner Mongolia University for the Nationalities, 2009Co-Authors: Meng Bang-zhuAbstract:Objective: To investigate the methods of rescue hyperosmolar Nonketotic Diabetic Coma(HNKDC) in wrinkly with heart, brain, kidney disease. Methods: Fluid infusion through gastrointestinal tract and vein at the same time. Supplied the cold cooked water through digestive tract, which accounting for 1/3 of fluid infusion volume, and infusion rate was 100～200ml/h, The volume of intravenous infusion fluid accounts for 2/3. Results: In 12 cases of HNKDC patients, 9 cases were successfully rescued, 2 patients died, 1 case gived up treatment and discharged, the mortality rate was 22.2%. Conclusion: The digestive tract and intravenous fluid infusion at the same time is a good way to rescue wrinkly with heart, brain, kidney disease complicated with hyperosmolar Nonketotic Diabetic Coma.
A Nakazawa - One of the best experts on this subject based on the ideXlab platform.
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Rhabdomyolysis related-acute renal failure in a patient with hyperosmolar Nonketotic Diabetic Coma (HNKC): demonstration of myoglobin casts after normalization of renal function
Nihon Jinzo Gakkai shi, 1996Co-Authors: A Nakazawa, A Ohishi, M Nakamura, K Kaneko, N Aosaki, H Sugiura, Y Miyoshi, K HamaguchiAbstract:We report a patient with rhabdomyolysis secondary to hyperosmolar Nonketotic Diabetic Coma (HNKC), who progressed to acute renal failure. A 43-year-old male with diabetes mellitus for three years was admitted to our hospital because of loss of consciousness. The laboratory findings at admission were as follows: serum glucose 1792 mg/dl, serum Na 129 mEq/1, BUN 71 mg/d1, serum creatinine 3.3 mg/d1, CPK 715 IU/1, plasma osmolality 370 mOsm/1, and negative urine ketone bodies. A diagnosis of HNKC was made. On the 2nd day, he had oliguria and the serum creatinine increased despite adequate treatment of HNKC by the administration of intravenous fluid and insulin. On the 4th day, CPK reached 47,300 IU/1, and serum myoglobin was also increased, indicating rhabdomyolysis. His renal function improved gradually and was almost normalized on the 20th day. Renal biopsy on the 23rd day showed myoglobin at the distal renal tubules, which appeared to be involved in the pathogenesis of renal failure by rhabdomyolysis. However, we found little abnormality association with Diabetic nephropathy in the renal tissue. Since HNKC is known to induce acute renal failure rarely without Diabetic nephropathy, these findings suggested that the acute renal failure was caused mainly by the rhabdomyolysis. Acute renal failure induced by rhabdomyolysis in patients with HNKC is rare, but fatal. The present study showed that the measurement of serum CPK and urine myoglobin was helpful for early diagnosis. Only 12 cases have been reported to have developed renal failure due to rhabdomyolysis among patients with HNKC. To our knowledge, we demonstrated for the first time that myoglobin at the distal renal tubules after renal function was normalized.
Linong Zeng - One of the best experts on this subject based on the ideXlab platform.
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clinical analysis of 16 patients with hyperosmolar Nonketotic Diabetic Coma
China Clinical Practical Medicine, 2008Co-Authors: Linong ZengAbstract:Objective To explore the clinical characteristics and treatment of hyperosmolar Nonketotic Diabetic Coma(HNDC). Methods The clinical data of 16 patients with HNDC,who received low dosage of in-sulin and large amount of fluid infusion was analyzed. Results 14 cases were rescued successfully,2 cases died. Conclusion The key of rescuing patients with HNDC is to make a corect diagnosis early,the use of low dosage of insulin as early as possible and the fluid replacement. Key words: Diabetes; Hperosmolar Nonketotic Diabetic Coma
Lei Min-xiang - One of the best experts on this subject based on the ideXlab platform.
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Clinical analysis of 63 patients with hyperosmolar Nonketotic Diabetic Coma
China Journal of Modern Medicine, 2005Co-Authors: Lei Min-xiangAbstract:To explore the new characteristic of the clinical manifestation and treatment of the hyperosmolar Nonketotic Diabetic Coma. To analyse the cases of 63 patients with hyperosmolar Nonketotic Coma by review investigation. In the cases of 63 patients, the infection was still major cause which initiated hyperosmolar nonkctotic Diabetic Coma. 39% patients suffered hyperosmolar Nonketotic Coma and ketacidosis at the same time. 25 patients with 5% glucose therapy were recovered. [Conclusion] Using 5% glucose to treat hyperosmolar Nonketotic Diabetic Coma is valuable.
