A Case of Non-diabetic Chronic Renal Failure in Which Hypoglycemia Due to Dialysis was Considered to Have Caused Seizures

We experienced a case of non-diabetic chronic renal failure in which hypoglycemia due to dialysis was considered to have caused seizures. The patient was a 64-year-old male with a previous history of chronic renal failure and alcoholic liver dysfunction. He was hospitalized at a critical care center on suspicion of a skull fracture and a brain contusion and received conservative medical treatment in November 2003. The patient su#ered seizures while undergoing dialysis on the second and the third hospital days, and hypoglycemia was observed. Glucose was administered intravenously whereupon the symptoms improved. The patient had no seizures after the fourth hospital day. Although having 2 seizures cannot rule out traumatic epilepsy, since only 2 days had passed after injury, and the dialysis induced the symptoms, it was considered that hypoglycemic coma accompanying the dialysis induced the seizures. The occurrence mechanism of hypoglycemia due to dialysis in a patient with non-diabetic chronic renal failure is not known. In this patient, dialysis under the condition that the lack of various amino acids caused by protein hypercatabolism due to chronic renal failure and the caloric intake deficiency immediately after admission were considered to be possible mechanisms of the hypoglycemia. Since there is a possibility that seizure of unknown cause during dialysis in a chronic dialysis patient was caused by hypoglycemia due to dialysis, it was considered that it was necessary to ascertain the nutritional status in detail by checking the blood sugar level during and immediately after dialysis and the amino acid analysis.