Effect of different levels of glucose in the dialysate on the risk of hypoglycemia during hemodialysis in diabetic patients

Correspondence to: Dr. Jayme Eduardo Burmeister. Departamento de Clínica Médica e Unidade de Medicina Renal Hospital Universitário Universidade Luterana do Brasil Canoas, RS. Av. Cel. Lucas de Oliveira, no 1270, apto. 30, Bela Vista, Porto Alegre, RS, Brazil. CEP: 90440-010. E-mail: [email protected] Introduction: Hypoglycemia can occur during hemodialysis in diabetic chronic renal failure patients when using a dialysate without glucose. With dialysis solutions with glucose 90 mg/dL or more, this is preventable, but diabetic patients could present higher intradialytic glycemias. Objective: We tested a dialytic fluid with a lower level of glucose trying to prevent both hypo and hyperglycemia in these patients. Methods: Twenty diabetic individuals from our hemodialysis unit were submitted to 3 sessions with dialysis solutions with two different glucose concentrations 55 mg/dL (Phase 55), and 90 mg/dL (Phase 90) and a glucose-free one (Phase ZERO). Plasma glucose levels were measured at five moments during each session before and at 30, 60, 90 and 240 min. Results under 70 mg/dL were considered as hypoglycemia. Results: Three patients presented 6 episodes of hypoglycemia in Phase 55, but no patient presented any episode in Phase 90. In Phase ZERO, five patients presented 7 episodes. Conclusion: This dialysate with a low level of glucose (55 mg/dL) did not prevent hypoglycemia episodes during hemodialysis in diabetic patients, these occurrences being similar to that when using a dialysate without glucose. The use of a 90 mg/dL glucose dialysis solution did not induce higher intradialytic glycemia levels than the other dialysis solutions. Effect of different levels of glucose in the dialysate on the risk of hypoglycemia during hemodialysis in diabetic patients