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CASE REPORT  NON-COVID-19 SECTION Open accessopen access

Italian Journal of Emergency Medicine 2021 August;10(2):98-100

DOI: 10.23736/S2532-1285.21.00075-6

Copyright © 2021 THE AUTHORS

This is an open access article distributed under the terms of the CC BY-NC-ND 4.0 license which allows users to copy and distribute the manuscript, as long as this is not done for commercial purposes and further does not permit distribution of the manuscript if it is changed or edited in any way, and as long as the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI) and provides a link to the license.

language: English

Extreme hyperkaliemia and interplay between ESRD, diabetes mellitus and binge use of cocaine and cannabis

Gioacchino LI CAVOLI , Onofrio SCHILLACI, Carmela ZAGARRIGO, Camillo CAROLLO, Franca SERVILLO, Carlo GIAMMARRESI, Angelo TRALONGO

Department of Nephrology Dialysis Renal Transplantation, Civic Hospital of Palermo, Palermo, Italy



The patients on long-term hemodialysis (HD) have high risk of hyperkaliemia. People with diabetes mellitus (DM) who abuse substances may carry greater health risks than the general population resulting from their effect on glucose metabolism. The use of cocaine and cannabis has been associated with increased risk for DKA among adults with type 1 DM. We reported our experience on a severe hyperkaliemia in a patient on long-term HD, hyperglycemic crisis and illicit drugs use (cocaine and cannabis). Electrocardiography showed typical changes of hyperkalemia, which regressed after started insulin infusion and prompt HD. In patients with anuria on HD, severe hyperglycemic states are rare but high levels of K+ to this extreme degree are rare. There are few studies regarding the interplay between ESRD, the lack of insulin and recreational and illicit drugs use leading to hyperglycemic states.


KEY WORDS: Cocaine; Cannabis; Diabetes mellitus; Hyperglycemia; Kidney failure, chronic

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