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  • Title: Risk of hypoglycemia during hemodialysis in diabetic patients is related to lower pre-dialysis glycemia.
    Author: Burmeister JE, Miltersteiner Dda R, Burmeister BO, Campos JF.
    Journal: Arch Endocrinol Metab; 2015 Apr; 59(2):137-40. PubMed ID: 25993676.
    Abstract:
    OBJECTIVE: To compare the occurrence of hypoglycemia during hemodialysis in chronic kidney disease diabetic patients who present different levels of pre-dialysis glycemia both when using dialysis solutions with and without glucose. SUBJECTS AND METHODS: Twenty type 2 diabetic patients in maintenance hemodialysis were submitted to three dialysis sessions (at a 7-day interval each) with dialysis solutions without glucose, with glucose at 55 mg/dL, and at 90 mg/dL subsequently. Blood glucose levels were measured immediately pre-dialysis and at 4 moments during the session, and values under 70 mg/dL were considered as hypoglycemia. RESULTS: Average pre-dialysis glycemia was lower in those who presented intra-dialytic hypoglycemia than in those who did not, both in glucose-free (140.4 ± 50.7 vs. 277.7 ± 91.0 mg/dL; p = 0.005; 95%CI: 46.4 to 228.1) and in glucose 55 mg/dL (89.5 ± 10.6 vs. 229.7 ± 105.0 mg/dL; p < 0.05; 95%CI: 9.8 to 270.5). In patients with pre-dialysis glycemia under 140 mg/dL, average intradialytic glycemia was significantly lower than pre-dialysis glycemia only when using glucose-free dialysate (p < 0.0001; 95%CI: 29.9 to 56.0 - t-test). Hypoglycemia during dialysis was observed only when using glucose-free or glucose-poor dialysis solutions. CONCLUSIONS: The use of glucose-free or glucose-poor dialysis solution presents a high risk of intradialytic hypoglycemia in diabetic renal patients, especially in those with presumed better glycemic control.
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