Journal of the Chinese Medical Association
Volume 70, Issue 7 , Pages 286-288, July 2007

Recurrent Hypoglycemia in a Hemodialysis Patient Related to Propoxyphene Treatment

  • Hui-Ting Lee

      Affiliations

    • Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Wei-Cheng Tseng

      Affiliations

    • Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Der-Cherng Tarng

      Affiliations

    • Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • Institutes of Physiology and Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Der-Cherng Tarng, Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.

Received 4 December 2006; accepted 22 May 2007.

Article Outline

There are various etiologies for hypoglycemia in patients with chronic renal failure, and its pathogenesis is complex. Concomitant use of medications is the most common cause. We report a rare case of an 82-year-old woman with type 2 diabetes mellitus in end-stage renal disease undergoing maintenance hemodialysis, who experienced recurrent symptomatic hypoglycemia during treatment with propoxyphene for pain relief. Hypoglycemia occurred simultaneously with elevated levels of serum immunoreactive insulin and C-peptide. After discontinuing propoxyphene, hypoglycemia mitigated and the level of insulin returned to normal range. Our case reminds us that propoxyphene-induced hypoglycemia should not be ignored, especially in hemodialysis patients with cold sweats, agitation and depressed consciousness.

Key Words:  hemodialysis , hypoglycemia , propoxyphene

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PII: S1726-4901(07)70006-0

doi:10.1016/S1726-4901(07)70006-0

Journal of the Chinese Medical Association
Volume 70, Issue 7 , Pages 286-288, July 2007

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