L. Aoun, Hadi Itani, Chris Kaspar, Michel Al Achkar, F. Saliba, Shaza Al Mardini, E. Abidor, M. Aldalahmeh, Zaid Khamis, Toni Habib, Fadi Haddadin, Waleed Azam, R. Dankar, Salim Barakat, Sai Shanmukha Sreeram Pannala, Julie Zaidan
2026.2.20ENDOCRINE RESEARCH
tlooto Summary
The prevalence, risk factors, and management of diabetic ketoacidosis and hyperosmolar hyperglycemic state in patients with end-stage renal disease on hemodialysis in patients with end-stage renal disease on hemodialysis is discussed.
Abstract
PURPOSE This review aims to discuss the prevalence, risk factors, and management of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) in patients with end-stage renal disease (ESRD) on hemodialysis.
METHODS A comprehensive literature review of retrospective studies, case reports, and clinical guidelines was conducted.
RESULTS DKA and HHS incidence is lower in ESRD patients due to delayed insulin clearance and regular dialysis. Management requires cautious fluid administration, reduced insulin infusion rates, conservative potassium replacement, and gradual correction of hyperosmolarity. Emergency hemodialysis may be necessary for severe acidosis or hyperkalemia.
CONCLUSION Treatment must be individualized. Emerging strategies, including extended dialysis sessions and closed-loop insulin delivery, require further validation.
Citation format
AOUN, L., et al. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in patients with end-stage renal disease on dialysis: A review. ENDOCRINE RESEARCH, 2026, 51(2): 59–67.