Peri‐dialytic hypoglycemia with hemodialysis and online post‐dilutional hemodiafiltration

Abstract

Introduction We wished to determine whether peri‐dialytic hypoglycemia is a clinical risk in contemporary dialysis patients using glucose containing dialysate. Methods We measured blood glucose pre‐ and post‐hemodialysis or hemodiafiltration, using 5.5 mmol/L glucose dialysate, and body composition by bioimpedance. Results Two hundred and thirty nine patients were studied, mean age 65 ± 15.4 years, 59.4% male, 46.4% diabetes, 81.6% treated by hemodiafiltration, five hemodiafiltration patients (2.1%) had hypoglycemia, with 82 (33%) a blood glucose < 5.5 mmol/L, with fewer diabetics (19.8 vs. 74.7%, p = 0.001), and %body fat (27.7 [20.6–32.6] vs. 34.7 [26.6–42.8]%, p = 0.001). Low post‐dialysis blood glucose was negatively associated with glycated hemoglobin (OR 0.94 [0.84–0.97], p = 0.004), weight (OR 0.94 [0.89–0.98], p = 0.009), and %body fat (OR 0.92 [0.86–0.98], p = 0.013). Conclusions Although hypoglycemia occurred in 2%, 33% had a blood glucose below dialysate glucose. Low post‐dialysis glucose was associated with lower glycated hemoglobin and body fat, suggesting nutritional status is important in determining the risk of peri‐dialytic hypoglycemia.

The effect of nonpharmacologic interventions for muscle cramps and restless‐leg syndrome in hemodialysis patients: A meta‐analysis of randomized controlled trials

“…Kidney failure is one of the most common chronic diseases worldwide, with an increasing incidence; and attracts attention with its high mortality and morbidity rates [1]. Hemodialysis (HD) has been used frequently in the treatment of patients with stage 5 chronic kidney disease [2]. Although HD is crucial for kidney failure patients, it also has several complications, which generally arise from fluid and electrolyte imbalance, including muscle-related symptoms, hypotension, fatigue, dry mouth, diarrhea, constipation, vomiting, nausea, dizziness, dry skin, and pruritus [2][3][4].…”