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VOLUME 19 , ISSUE 7 ( 2015 ) > List of Articles

CASE REPORT

Reversal of severe lactic acidosis with thiamine in a renal allograft recipient

Nanda Kumar K., Veena R. Shah, Beena K. Parikh, Sumedha Sonde

Keywords : lactic acidosis, renal transplantation, thiamine deficiency,chronic hemodialysis

Citation Information : K. NK, Shah VR, Parikh BK, Sonde S. Reversal of severe lactic acidosis with thiamine in a renal allograft recipient. Indian J Crit Care Med 2015; 19 (7):425-428.

DOI: 10.4103/0972-5229.160293

License: CC BY-ND 3.0

Published Online: 00-07-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

A 48-year-old female patient with end-stage renal failure developed unexplained severe lactic acidosis (LA) associated with hyperglycemia during robotic-assisted laparoscopic renal transplantation. Initial treatment with sodium bicarbonate and insulin infusion were ineffective in treating acidemia. Postoperatively, intravenous administration of thiamine resulted in rapid improvement of LA and blood sugar levels. Uremia and chronic hemodialysis might be the causes behind the quantitative/qualitative deficiency of thiamine unmasked during the surgical stress. Though a rare entity, acute thiamine deficiency should be considered in the differential diagnosis of unexplained severe LA in patients with chronic kidney disease and hemodialysis who undergo major surgery or admitted to critical illness care units.


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