Euglycemic Diabetic Ketoacidosis With Acute Renal Failure: A Challenging Case for Clinicians

Diabetic ketoacidosis (DKA) is a severe complication of diabetes mellitus characterized by hyperglycemia, metabolic acidosis, and ketosis. We present a challenging case of euglycemic DKA secondary to fasting and urinary tract infection with acute renal failure in a 50-year-old woman. Despite normal...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-05, Vol.16 (5), p.e60171
Main Authors: Rizwanullah, Ahmadi, Tahera, Ahmad, Aftab, Khan, Waqar, Rosario-Curcio, Jose C
Format: Article
Language:English
Subjects:
Abdomen
Acidosis
Antidiabetics
Case reports
Coma
Creatinine
Diabetes
Diabetic ketoacidosis
Electrolytes
Endocrinology/Diabetes/Metabolism
Fasting
Glucose
Hemodialysis
Hemoglobin
Hyperkalemia
Insulin
Internal Medicine
Ketosis
Kidney diseases
Metabolism
Mortality
Nephrology
Patients
Uremia
Urinary tract infections
Urine
Vomiting
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Summary:Diabetic ketoacidosis (DKA) is a severe complication of diabetes mellitus characterized by hyperglycemia, metabolic acidosis, and ketosis. We present a challenging case of euglycemic DKA secondary to fasting and urinary tract infection with acute renal failure in a 50-year-old woman. Despite normal random blood sugar levels, the patient exhibited clinical signs of DKA, leading to further investigation. High anion gap metabolic acidosis with hyperkalemia and abnormal renal function tests were identified. After hemodialysis, serum ketones were found to be highly positive, confirming the diagnosis. Prompt management led to a complete clinical and laboratory resolution. This case underscores the importance of considering DKA in patients with suggestive symptoms, even with normal blood sugar levels.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.60171