We report a CAPD patient with peritonitis who developed spontaneous hypoglycemia. In spite of dialysis with hypertonic solutions and intravenous infusions of dextrose, the plasma glucose remained low. Subsequently the patient was found to be suffering from acute liver failure; hypoglycemia improved only when liver function improved four days later.
In previously reported cases of spontaneous hypoglycemia among patients on hemodialysis, the main causes seem to have been impaired hepatic gluconeogenesis due to Bblockade, mild hepatic necrosis or some specific effect of azotemia on hepatic enzymes
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