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Can Dka Cause Renal Failure?

Diabetic Ketoacidosis: Evaluation And Treatment

Diabetic Ketoacidosis: Evaluation And Treatment

Diabetic ketoacidosis is characterized by a serum glucose level greater than 250 mg per dL, a pH less than 7.3, a serum bicarbonate level less than 18 mEq per L, an elevated serum ketone level, and dehydration. Insulin deficiency is the main precipitating factor. Diabetic ketoacidosis can occur in persons of all ages, with 14 percent of cases occurring in persons older than 70 years, 23 percent in persons 51 to 70 years of age, 27 percent in persons 30 to 50 years of age, and 36 percent in persons younger than 30 years. The case fatality rate is 1 to 5 percent. About one-third of all cases are in persons without a history of diabetes mellitus. Common symptoms include polyuria with polydipsia (98 percent), weight loss (81 percent), fatigue (62 percent), dyspnea (57 percent), vomiting (46 percent), preceding febrile illness (40 percent), abdominal pain (32 percent), and polyphagia (23 percent). Measurement of A1C, blood urea nitrogen, creatinine, serum glucose, electrolytes, pH, and serum ketones; complete blood count; urinalysis; electrocardiography; and calculation of anion gap and osmolar gap can differentiate diabetic ketoacidosis from hyperosmolar hyperglycemic state, gastroenteritis, starvation ketosis, and other metabolic syndromes, and can assist in diagnosing comorbid conditions. Appropriate treatment includes administering intravenous fluids and insulin, and monitoring glucose and electrolyte levels. Cerebral edema is a rare but severe complication that occurs predominantly in children. Physicians should recognize the signs of diabetic ketoacidosis for prompt diagnosis, and identify early symptoms to prevent it. Patient education should include information on how to adjust insulin during times of illness and how to monitor glucose and ketone levels, as well as i Continue reading >>

Diabetes Medication May Lead To Diabetic Ketoacidosis, Renal Failure, Cardiovascular Risks, Heart Attack And Stroke

Diabetes Medication May Lead To Diabetic Ketoacidosis, Renal Failure, Cardiovascular Risks, Heart Attack And Stroke

How does it work? Invokana deals with excess blood sugar through utilizing a “short-circuit solution”. The drug does not metabolize sugar, but instead brings all of the body’s glucose to the kidneys and blocks reabsorption. This is an unnatural emergency mechanism which can overload the kidneys. Additionally, the body has no sugar to utilize for energy so it cannibalizes and pulls sugar from glucose found in both fat and muscle. What complications have resulted from usage? Invokana has recently been linked with diabetic ketoacidosis and osteoporosis. Diabetic ketoacidosis is a serious diabetes complication where the body produces excess blood acids (ketones). This can then lead to renal failureand various cardiovascular risks. Osteoporosis decreases bone strength and increases the risk of broken bones. Heart attack and stroke are other potential side effects not noted on the warning labels of the product. How do I know if I have diabetic ketoacidosis? The FDA recommends that people taking these prescriptions look for symptoms of ketoacidosis including difficulty breathing, vomiting, nausea, confusion, unusual fatigue, or abdominal pain. If you have experienced any of these symptoms, you should seek emergency medical treatment. Contact an Experienced Attorney – Get a Free Case Evaluation With over three decades of experience, the law firm of Rudolph F.X. Migliore, P.C. is positioned to help those who have been harmed by these medications. Our law firm works with nationally recognized associated firms to reach major verdicts and settlements. Call our New York office at (631) 543-3663 to arrange a no cost, no obligation consultation to find out how an attorney can help you. Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Also known as: DKA Severe diabetic ketoacidosis is a medical emergency and requires prompt treatment to correct dehydration, electrolyte disturbances and acidosis. It is a complication of insulin dependent Diabetes Mellitus. DKA is the result of marked insulin deficiency, and ketonaemia and ketoacidosis occur approximately 15 days after insulin concentrations are suppressed to fasting levels. Marked insulin suppression occurs on average 4 days after fasting glucose levels reach 30mmol/L. Many cats with DKA have other intercurrent conditions which may precipitate the condition including: infection, pancreatitis or renal insufficiency. Pathophysiology Insulin deficiency leads to increased breakdown of fat that releases fatty acids into the circulation. Free fatty acids are oxidised in the liver to ketones that are used by many tissues as an energy source instead of glucose. This occurs when intracellular levels of glucose are insufficient for energy metabolism as a result of severe insulin deficiency. In the liver, instead of being converted to triglycerides, free fatty acids are oxidised to acetoacetate, which is converted to hydroxybutyrate or acetone. Ketones are acids that cause central nervous system depression and act in the chemoreceptor trigger zone to cause nausea, vomiting and anorexia. They also accelerate osmotic water loss in the urine. Dehydration results from inadequate fluid intake in the face of accelerated water loss due to glucosuria and ketonuria. Dehydration and subsequent reduced tissue perfusion compounds the acidosis through lactic acid production. There is whole body loss of electrolytes including sodium, potassium, magnesium and phosphate and there is also intracellular redistribution of electrolytes following insulin therapy which may compound p Continue reading >>

Diabetes And Kidney Failure (stage 5)

Diabetes And Kidney Failure (stage 5)

What is diabetes? Diabetes happens when your body does not make enough insulin or cannot use insulin properly. Insulin is a hormone. It controls how much sugar is in your blood. A high level of sugar in your blood can cause damage to the very small blood vessels in your kidneys. Over time, this can lead to kidney disease and kidney failure. What is kidney failure? Healthy kidneys do many important jobs. They filter your blood, keep fluids in balance, and make hormones that help your body control blood pressure, have healthy bones, and make red blood cells. If you have kidney failure, it means your kidneys have stopped working well enough to do these important jobs and keep you alive. As a result: Harmful wastes build up in your body Your blood pressure may rise Your body may hold too much fluid Your body cannot make enough red blood cells When this happens, you need treatment to replace the work of your failed kidneys. There is no cure for kidney failure. A person with kidney failure needs treatment to live. Three types of treatment can be used if your kidneys have failed: Hemodialysis Peritoneal dialysis Kidney transplantation Your healthcare team will discuss these different treatments with you and answer all your questions. They will help you choose the best treatment for you, based on your general health, lifestyle, and treatment preference. Your decision does not need to be final. Many people have used each one of these treatments at different times in their lifetime. If I have kidney failure and diabetes, what will my treatment involve? A kidney doctor (called a nephrologist) will plan your treatment with you, your family, and your dietitian. In addition to dialysis or a transplant, you will need to: Keep your blood sugar under control. This is usually done with d Continue reading >>

Feline Chronic Kidney Disease

Feline Chronic Kidney Disease

ON THIS PAGE: Risk Factors Home > Related Diseases > Diabetes It is not uncommon for a CKD cat to also have or develop diabetes. The dietary needs of a diabetic cat may seem incompatible with the needs of a CKD cat but the diabetes must take precedence. What is Diabetes Mellitus? Insulin is a hormone which enables the body to process food and to produce energy from it. Diabetes mellitus is a disease in which: not enough insulin is produced by the pancreas; or the cat’s body cells do not properly process insulin which the pancreas has produced. As a result, the cat develops high blood sugar levels (hyperglycaemia), which eventually lead to high sugar levels in the urine (glucosuria). Diabetes may present as: uncomplicated; or diabetes with ketoacidosis (DKA) Cats with the former may only have mild symptoms, at least in the early stages, but cats with ketoacidosis are usually very ill, and may die if not treated promptly. There is another, much rarer form of diabetes called diabetes insipidus which is beyond the scope of this website. Cornell University College of Veterinary Medicine has a good general overview of diabetes in cats. Feline diabetes mellitus: from diagnosis to therapy (2009) is a helpful article by Dr DL Zoran. Feline Diabetes provides detailed answers to frequently asked questions. Risk Factors Increasing age is a factor (as it is for CKD cats). Steroid-induced diabetes in cats (2013) Peterson ME Veterinary Endocrinology says "The average age at diagnosis for feline diabetes is 10 years, with a peak incidence between 9 and 13 years." Obesity in cats, as in humans, is a strong predisposing factor for diabetes. For some reason, male cats and neutered cats are more at risk of diabetes. Burmese cats in the UK and Australasia (but not the USA) appear to be mo Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Introduction Diabetic ketoacidosis (DKA) is a dangerous complication of diabetes caused by a lack of insulin in the body. Diabetic ketoacidosis occurs when the body is unable to use blood sugar (glucose) because there isn't enough insulin. Instead, it breaks down fat as an alternative source of fuel. This causes a build-up of a by-product called ketones. Most cases of diabetic ketoacidosis occur in people with type 1 diabetes, although it can also be a complication of type 2 diabetes. Symptoms of diabetic ketoacidosis include: passing large amounts of urine feeling very thirsty vomiting abdominal pain Seek immediate medical assistance if you have any of these symptoms and your blood sugar levels are high. Read more about the symptoms of diabetic ketoacidosis. Who is affected by diabetic ketoacidosis? Diabetic ketoacidosis is a relatively common complication in people with diabetes, particularly children and younger adults who have type 1 diabetes. Younger children under four years of age are thought to be most at risk. In about 1 in 4 cases, diabetic ketoacidosis develops in people who were previously unaware they had type 1 diabetes. Diabetic ketoacidosis accounts for around half of all diabetes-related hospital admissions in people with type 1 diabetes. Diabetic ketoacidosis triggers These include: infections and other illnesses not keeping up with recommended insulin injections Read more about potential causes of diabetic ketoacidosis. Diagnosing diabetic ketoacidosis This is a relatively straightforward process. Blood tests can be used to check your glucose levels and any chemical imbalances, such as low levels of potassium. Urine tests can be used to estimate the number of ketones in your body. Blood and urine tests can also be used to check for an underlying infec Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Professor of Pediatric Endocrinology University of Khartoum, Sudan Introduction DKA is a serious acute complications of Diabetes Mellitus. It carries significant risk of death and/or morbidity especially with delayed treatment. The prognosis of DKA is worse in the extremes of age, with a mortality rates of 5-10%. With the new advances of therapy, DKA mortality decreases to > 2%. Before discovery and use of Insulin (1922) the mortality was 100%. Epidemiology DKA is reported in 2-5% of known type 1 diabetic patients in industrialized countries, while it occurs in 35-40% of such patients in Africa. DKA at the time of first diagnosis of diabetes mellitus is reported in only 2-3% in western Europe, but is seen in 95% of diabetic children in Sudan. Similar results were reported from other African countries . Consequences The latter observation is annoying because it implies the following: The late diagnosis of type 1 diabetes in many developing countries particularly in Africa. The late presentation of DKA, which is associated with risk of morbidity & mortality Death of young children with DKA undiagnosed or wrongly diagnosed as malaria or meningitis. Pathophysiology Secondary to insulin deficiency, and the action of counter-regulatory hormones, blood glucose increases leading to hyperglycemia and glucosuria. Glucosuria causes an osmotic diuresis, leading to water & Na loss. In the absence of insulin activity the body fails to utilize glucose as fuel and uses fats instead. This leads to ketosis. Pathophysiology/2 The excess of ketone bodies will cause metabolic acidosis, the later is also aggravated by Lactic acidosis caused by dehydration & poor tissue perfusion. Vomiting due to an ileus, plus increased insensible water losses due to tachypnea will worsen the state of dehydr Continue reading >>

Acute Pancreatitis With Diabetic Ketoacidosis Associated With Hypermyoglobinemia, Acute Renal Failure, And Dic

Acute Pancreatitis With Diabetic Ketoacidosis Associated With Hypermyoglobinemia, Acute Renal Failure, And Dic

Abstract We report a case of acute pancreatitis with diabetic ketoacidosis associated with increased serum myoglobin concentration, acute renal failure, and disseminated intravascular coagulation. A 49-year-old man suffering from diarrhea, vomiting, and somnolence was admitted to the hospital. He had had flu-like symptoms for 4 days prior to the onset of these symptoms. He was a habitual drinker and had been consuming 360 ml–900 ml of the drink “shochu” (distilled spirits containing 28% alcohol) daily for 30 years. Laboratory data on admission revealed elevated serum levels of pancreatic enzymes, including amylase, trypsin, lipase, pancreatic secretory trypsin inhibitor (PSTI), phospholipase A2 (PLA2), and elastase-1, as well as elevated levels of glucose (373 mg/dl), ketone bodies (3675 μmol/l), and myoglobin (229.8 ng/ml). Treatment with subcutaneous insulin and intravenous administration of electrolyte fluid and the systemic protease inhibitor, gabexate mesilate, was begun immediately. Early after the initiation of treatment, there was an increase in serum cretinine (4.9 mg/dl), and thrombocytopenia (15000/μl) was observed. The patient completely recovered from renal failure and acute pancreatitis, but required insulin therapy. Alcohol ingestion and dehydration are thought to have played a major role in the triggering of the acute pancreatitis, We examined the relationship among acute pancreatitis, diabetic ketoacidosis, and hypermyoglobinemia in the literature. Preview Unable to display preview. Download preview PDF. Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also the separate Childhood Ketoacidosis article. Diabetic ketoacidosis (DKA) is a medical emergency with a significant morbidity and mortality. It should be diagnosed promptly and managed intensively. DKA is characterised by hyperglycaemia, acidosis and ketonaemia:[1] Ketonaemia (3 mmol/L and over), or significant ketonuria (more than 2+ on standard urine sticks). Blood glucose over 11 mmol/L or known diabetes mellitus (the degree of hyperglycaemia is not a reliable indicator of DKA and the blood glucose may rarely be normal or only slightly elevated in DKA). Bicarbonate below 15 mmol/L and/or venous pH less than 7.3. However, hyperglycaemia may not always be present and low blood ketone levels (<3 mmol/L) do not always exclude DKA.[2] Epidemiology DKA is normally seen in people with type 1 diabetes. Data from the UK National Diabetes Audit show a crude one-year incidence of 3.6% among people with type 1 diabetes. In the UK nearly 4% of people with type 1 diabetes experience DKA each year. About 6% of cases of DKA occur in adults newly presenting with type 1 diabetes. About 8% of episodes occur in hospital patients who did not primarily present with DKA.[2] However, DKA may also occur in people with type 2 diabetes, although people with type 2 diabetes are much more likely to have a hyperosmolar hyperglycaemic state. Ketosis-prone type 2 diabetes tends to be more common in older, overweight, non-white people with type 2 diabetes, and DKA may be their Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetes mellitus is the name given to a group of conditions whose common hallmark is a raised blood glucose concentration (hyperglycemia) due to an absolute or relative deficiency of the pancreatic hormone insulin. In the UK there are 1.4 million registered diabetic patients, approximately 3 % of the population. In addition, an estimated 1 million remain undiagnosed. It is a growing health problem: In 1998, the World Health Organization (WHO) predicted a doubling of the worldwide prevalence of diabetes from 150 million to 300 million by 2025. For a very tiny minority, diabetes is a secondary feature of primary endocrine disease such as acromegaly (growth hormone excess) or Cushing’s syndrome (excess corticosteroid), and for these patients successful treatment of the primary disease cures diabetes. Most diabetic patients, however, are classified as suffering either type 1 or type 2 diabetes. Type 1 diabetes Type 1 diabetes, which accounts for around 15 % of the total diabetic population, is an autoimmune disease of the pancreas in which the insulin-producing β-cells of the pancreas are selectively destroyed, resulting in an absolute insulin deficiency. The condition arises in genetically susceptible individuals exposed to undefined environmental insult(s) (possibly viral infection) early in life. It usually becomes clinically evident and therefore diagnosed during late childhood, with peak incidence between 11 and 13 years of age, although the autoimmune-mediated β-cell destruction begins many years earlier. There is currently no cure and type 1 diabetics have an absolute life-long requirement for daily insulin injections to survive. Type 2 diabetes This is the most common form of diabetes: around 85 % of the diabetic population has type 2 diabetes. The primary prob Continue reading >>

Management Of A Dka Patient With Severe Metabolic And Ketoacidosis With Chronic Renal Insufficiency Brian Albany Otterbein University, Boomer.albany@otterbein.edu

Management Of A Dka Patient With Severe Metabolic And Ketoacidosis With Chronic Renal Insufficiency Brian Albany Otterbein University, [email protected]

Otterbein University Digital Commons @ Otterbein MSN Student Scholarship Student Research & Creative Work Fall 2014 Follow this and additional works at: Part of the Endocrine System Diseases Commons, Medical Pathology Commons, and the Nursing Commons This Project is brought to you for free and open access by the Student Research & Creative Work at Digital Commons @ Otterbein. It has been accepted for inclusion in MSN Student Scholarship by an authorized administrator of Digital Commons @ Otterbein. For more information, please contact [email protected] Recommended Citation Albany, Brian, "Management of a DKA patient with severe metabolic and ketoacidosis with chronic renal insufficiency" (2014). MSN Student Scholarship. Paper 6. Implications for nursing care Management of a DKA patient with severe metabolic and ketoacidosis with chronic renal insufficiency Brian Albany BSN, CCRN Introduction Case Study References Underlying Pathophysiology Diabetic ketoacidosis (DKA) serves as one the leading causes of mortality in diabetic patients [14]. The mortality has decreased over the past several decades due to the rapid recognition of the disease state and the improvement of management of DKA [14]. Despite a decline in mortality rates over the past twenty years from 7.96% to 0.67%, errors in management of the disease state are associated with significant morbidity and mortality [2]. Utilization of DKA protocols in the acute care setting have allowed congruency in care and delivery of effective lifesaving treatment. Despite advances in standardized DKA protocols, there still remains a gap in how to manage specific patient populations with end stage renal disease. Understanding the pathophysiology behind these patient populations will yield better outcomes with the ultimate Continue reading >>

Severe Acute Renal Failure In A Patient With Diabetic Ketoacidosis

Severe Acute Renal Failure In A Patient With Diabetic Ketoacidosis

1 King Khalid National Guard Hospital, Jeddah, Kingdom of Saudi Arabia, Department of Pediatrics, Division of Nephrology, Children's Hospital of Eastern Ontario, Ottawa, Canada, Canada 2 Department of Pediatrics, Division of Nephrology, Children's Hospital of Eastern Ontario, Ottawa, Canada Click here for correspondence address and email Acute renal failure (ARF) is a rare but potentially fatal complication of diabetic ketoacidosis (DKA). Early recognition and aggressive treatment of ARF during DKA may improve the prognosis of these patients. We present a case report of a 12 year old female admitted to the hospital with severe DKA as the 1s t manifestation of her diabetes mellitus. She presented with severe metabolic acidosis, hypophosphatemia, and oliguric ARF. In addition, rhabdomyolysis was noted during the course of DKA which probably contributed to the ARF. Management of DKA and renal replacement therapy resulted in quick recovery of renal function. We suggest that early initiation of renal replacement therapy for patients with DKA developing ARF may improve the potentially poor outcome of patients with ARF associated with DKA. How to cite this article: Al-Matrafi J, Vethamuthu J, Feber J. Severe acute renal failure in a patient with diabetic ketoacidosis. Saudi J Kidney Dis Transpl 2009;20:831-4 Diabetic ketoacidosis (DKA) occurs in 10 to 70% of children with type 1 diabetes mellitus (DM1) and has a significant risk of mortality, mostly due to cerebral edema. [1] Other potential complications of DKA include hypokalemia, hypophosphatemia, hypoglycemia, intracerebral and peripheral venous thrombosis, mucormycosis, rhabdomyolysis, acute pancreatitis, acute renal failure (ARF) and sepsis. The development of ARF with rhabdomyolysis is a rare but potentially lethal diso Continue reading >>

Renal Failure

Renal Failure

Renal failure, especially CRF (Chronic renal failure), is a fairly common condition in older cats and dogs. The kidneys become less and less efficient at removing wastes[1] from the blood. CRF can sometimes be mistaken for diabetes, since polyuria and polydipsia can occur in both; this may lead to incorrect treatment and progression of the renal failure[2][3]. Diabetes can affect all bodily organs. Many humans with long-term diabetes have some problems relating to the kidneys, including diabetic nephropathy. There are many people who are renal dialysis patients and on renal transplant lists who are also diabetes patients. When CRF occurs in a diabetic pet, things can get tricky, since diabetes and CRF can complicate each other: prolonged hyperglycemia can lead to diabetic nephropathy. CRF can make it harder to regulate blood glucose levels. Insulin is metabolized mainly through the liver and kidneys[5][6]. The term used in references such as Physicians' Desk Reference and other medication information is reduced renal clearance, for the kidneys, reduced hepatic clearance for the liver. When the system processes insulin (and other medications) at a slower than normal rate, they remain in the system longer[7]. In the case of insulin, a previously acceptable dosage may lead to hypoglycemia, because it takes longer for the kidneys and/or liver to render it useless. Renal problems seem to affect the clearance of insulin more than disorders of the liver[8]. CRF and high blood pressure are both possible complications of diabetes, and of each other. See blindness. Continue reading >>

The Invokana Lawsuit - Amputations, Ketoacidosis & Kidney Injuries

The Invokana Lawsuit - Amputations, Ketoacidosis & Kidney Injuries

The Invokana lawsuits claim the manufacturers of Invokana failed to warn patients and physicians of the increased risks of amputations, kidney failure and ketoacidosis. Our law firm is accepting clients who took Invokana and suffered any of the above injuries. We have been handling claims against pharmaceutical companies since 1955, and we are listed in Best Lawyers in America and The National Trial Lawyers Hall of Fame. Why are Invokana Lawsuits Being Filed Thousands of claims have been filed against Johnson & Johnson and Janssen Pharmaceuticals by individuals who have suffered injuries as a result of taking Invokana. The lawsuits are presently combined before a federal judge in New Jersey where all of the national discovery and evidence gathering is taking place. Invokana linked to amputations, kidney damage and ketoacidosis. Yet, the manufacturers failed to properly warn. In the court filings, lawyers argue the following: Invokana is defective and unreasonably dangerous. Johnson & Johnson was negligent in the manufacturing of the drug. The company failed to properly test the medication, and failed to warn of the increased risks of amputations, kidney failure and ketoacidosis. Johnson & Johnson concealed evidence of the dangers from the government and the public, and misrepresented the safety of the drug in its marketing material. The most serious potential side effects and risks caused by Invokana are amputations, kidney damage and ketoacidosis. Clinical trials have found that patients taking Invokana are twice as likely to suffer a leg or foot amputation as those taking a placebo. Toe amputations and those in the middle of the foot are most common. Individuals taking Invokana should be especially careful to look for signs of increased tenderness, sores, ulcers, and Continue reading >>

Diabetic Ketoacidosis Producing Extreme Hyperkalemia In A Patient With Type 1 Diabetes On Hemodialysis

Diabetic Ketoacidosis Producing Extreme Hyperkalemia In A Patient With Type 1 Diabetes On Hemodialysis

Hodaka Yamada1, Shunsuke Funazaki1, Masafumi Kakei1, Kazuo Hara1 and San-e Ishikawa2[1] Division of Endocrinology and Metabolism, Jichi Medical University Saitama Medical Center, Saitama, Japan [2] Division of Endocrinology and Metabolism, International University of Health and Welfare Hospital, Nasushiobara, Japan Summary Diabetic ketoacidosis (DKA) is a critical complication of type 1 diabetes associated with water and electrolyte disorders. Here, we report a case of DKA with extreme hyperkalemia (9.0 mEq/L) in a patient with type 1 diabetes on hemodialysis. He had a left frontal cerebral infarction resulting in inability to manage his continuous subcutaneous insulin infusion pump. Electrocardiography showed typical changes of hyperkalemia, including absent P waves, prolonged QRS interval and tented T waves. There was no evidence of total body water deficit. After starting insulin and rapid hemodialysis, the serum potassium level was normalized. Although DKA may present with hypokalemia, rapid hemodialysis may be necessary to resolve severe hyperkalemia in a patient with renal failure. Patients with type 1 diabetes on hemodialysis may develop ketoacidosis because of discontinuation of insulin treatment. Patients on hemodialysis who develop ketoacidosis may have hyperkalemia because of anuria. Absolute insulin deficit alters potassium distribution between the intracellular and extracellular space, and anuria abolishes urinary excretion of potassium. Rapid hemodialysis along with intensive insulin therapy can improve hyperkalemia, while fluid infusions may worsen heart failure in patients with ketoacidosis who routinely require hemodialysis. Background Diabetic ketoacidosis (DKA) is a very common endocrinology emergency. It is usually associated with severe circulatory Continue reading >>

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