CASE REPORT  NON-COVID-19 SECTION Open 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 under the CC BY-NC-ND license

lingua: Inglese

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