糖尿病における腹腔灌流 : 腹腔内インシュリン投与の1例 ; Peritoneal dialysis for diabetic nephropathy: a case of intraperitoneal insulin administration

A 71-year-old company director with a history of diabetes since his age of 30 years was admitted to the Department of Urology, Wakayama Medical College Hospital with a diagnosis of acute renal failure. The clinical course became complicated by the development of anuria, a rise in blood pressure, and a fall in blood pH to 7.325. Blood creatinine level was 9.47 mg/dl and BUN level was 80 mg/dl. Intermittent peritoneal dialysis has been described as an adjunct in therapy of diabetic renal failure as blood sugar levels are easily regulated by intraperitoneal administration of insulin. In this case, 500 ml of ELR-l solution containing 10 units of regular insulin was used. Urine output of 3, 600 ml on the 7th day of hospital admission showed a subsequent decrease to about 1, 000 ml per day, and within two months period the BUN level decreased from 80 mg/dl to 27.7 mg/dl. Intermittent peritoneal dialysis is therefore indicated in the treatment of diabetic nephropathy, especially during acute renal failure.