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Kumar KN, Shah VR, Parikh BK, et al. Reversal of severe lactic acidosis with thiamine in a renal allograft recipient. Indian J Crit Care Med. 2015;19(7):425-8doi: 10.4103/0972-5229.160293.
Kumar, K. N., Shah, V. R., Parikh, B. K., & Sonde, S. (2015). Reversal of severe lactic acidosis with thiamine in a renal allograft recipient. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 19(7), 425-8. https://doi.org/10.4103/0972-5229.160293
Kumar, K Nanda, et al. "Reversal of severe lactic acidosis with thiamine in a renal allograft recipient." Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine vol. 19,7 (2015): 425-8. doi: https://doi.org/10.4103/0972-5229.160293
Kumar KN, Shah VR, Parikh BK, Sonde S. Reversal of severe lactic acidosis with thiamine in a renal allograft recipient. Indian J Crit Care Med. 2015 Jul;19(7):425-8. doi: 10.4103/0972-5229.160293. PMID: 26180438; PMCID: PMC4502498.
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Indian J Crit Care Med. 2015 Jul;19(7):425-8. doi: 10.4103/0972-5229.160293.

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

Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine

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

Affiliations

  1. Department of Anaesthesia and Critical Care, Smt. K. M. Mehta and Smt. G.R. Doshi Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad, Gujarat, India.

PMID: 26180438 PMCID: PMC4502498 DOI: 10.4103/0972-5229.160293

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.

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

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