Dialysis-induced respiratory acidosis.
The inability to increase alveolar ventilation can lead to CO2 retention and acute respiratory acidosis in patients with ventilatory limitation. In this case, a young woman receiving maximum ventilatory support was unable to excrete excess CO2, associated with increasing dianeal concentrations of peritoneal dialysis. Since the patient's lung disease had necessitated a large amount of ventilatory support, the patient was unable to increase VE appropriately to handle excess CO2. Peritoneal dialysate was an additional source of carbohydrates. Peritoneal dialysate is an additional carbohydrate source that may result in hypercapnia and respiratory acidosis in patients with respiratory compromise. To our knowledge, this is the first case report in an adult which demonstrates that peritoneal dialysis with high glucose loads produced an acute respiratory acidosis that was reversed by decreasing the glucose concentrations in the dialysate. Excess CO2 production should be considered with respiratory disorders associated with dialysis.
Cohn
J
J
Department of Internal Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago.
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D000142:Acidosis, Respiratory / Q000209:etiology*; D000328:Adult; D015314:Dialysis Solutions / Q000009:adverse effects*; D005260:Female; D005947:Glucose / Q000009:adverse effects*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000628:therapy; D010530:Peritoneal Dialysis; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000628:therapy
D015314:Dialysis Solutions; D005947:Glucose