On eight separate occasions, four functionally anephric diabetic patients (on maintenance hemodialysis) experienced episodes of severe hyperglycemia with acute interstitial and alveolar pulmonary edema demonstrated clinically and by chest x-ray without electrocardiographic or enzymatic evidence of an acute myocardial lesion. Three patients had normal stress 201Tl scanning. The fourth patient, who experienced three such episodes, had normal coronary angiograms and only a mild elevation of the left-ventricular end-diastolic pressure. Clinical and chest x-ray improvement were immediate following insulin therapy and control of hyperglycemia, without phlebotomy or dialysis. Since these episodes were observed during a 1-yr period, this syndrome may be more common than suspected. It is concluded that in functionally anephric diabetic individuals: (1) pulmonary edema can be precipitated by uncontrolled diabetes; (2) endogenous fluid shifts may contribute to the cause of acute pulmonary edema; (3) clinical and radiologic improvement can be achieved with adequate insulin therapy; and (4) blood glucose levels should be monitored and controlled in diabetic patients with renal failure.
Skip Nav Destination
Article navigation
Original Articles|
September 01 1982
Reversible Acute Pulmonary Edema due to Uncontrolled Hyperglycemia in Diabetic Individuals with Renal Failure
Antoine Kaldany;
Antoine Kaldany
Joslin Clinic Renal Unit and Elliott P. Joslin Research Laboratory, Divisions of Joslin Diabetes Center, Inc., and the Departments of Medicine, New England Deaconess Hospital and Harvard Medical School
Boston, Massachusetts
Search for other works by this author on:
Gregory A Curt;
Gregory A Curt
Joslin Clinic Renal Unit and Elliott P. Joslin Research Laboratory, Divisions of Joslin Diabetes Center, Inc., and the Departments of Medicine, New England Deaconess Hospital and Harvard Medical School
Boston, Massachusetts
Search for other works by this author on:
N Mark Estes;
N Mark Estes
Joslin Clinic Renal Unit and Elliott P. Joslin Research Laboratory, Divisions of Joslin Diabetes Center, Inc., and the Departments of Medicine, New England Deaconess Hospital and Harvard Medical School
Boston, Massachusetts
Search for other works by this author on:
Larry A Weinrauch;
Larry A Weinrauch
Joslin Clinic Renal Unit and Elliott P. Joslin Research Laboratory, Divisions of Joslin Diabetes Center, Inc., and the Departments of Medicine, New England Deaconess Hospital and Harvard Medical School
Boston, Massachusetts
Search for other works by this author on:
A Richard Christlieb;
A Richard Christlieb
Joslin Clinic Renal Unit and Elliott P. Joslin Research Laboratory, Divisions of Joslin Diabetes Center, Inc., and the Departments of Medicine, New England Deaconess Hospital and Harvard Medical School
Boston, Massachusetts
Search for other works by this author on:
John A D'elia
John A D'elia
Joslin Clinic Renal Unit and Elliott P. Joslin Research Laboratory, Divisions of Joslin Diabetes Center, Inc., and the Departments of Medicine, New England Deaconess Hospital and Harvard Medical School
Boston, Massachusetts
Search for other works by this author on:
Address reprint requests to Antoine Kaldany, Joslin Diabetes Center, Inc., One Joslin Place, Boston, Massachusetts 02215.
Citation
Antoine Kaldany, Gregory A Curt, N Mark Estes, Larry A Weinrauch, A Richard Christlieb, John A D'elia; Reversible Acute Pulmonary Edema due to Uncontrolled Hyperglycemia in Diabetic Individuals with Renal Failure. Diabetes Care 1 September 1982; 5 (5): 506–511. https://doi.org/10.2337/diacare.5.5.506
Download citation file: