The influence of different glucose concentrations in haemodialysis solutions on metabolism and blood pressure stability in diabetic patients.
In recent years the percentage of diabetic patients on haemodialysis has increased. Considering the high frequency of intradialytic hypotensive and hypoglycaemic episodes experienced by these patients, it was the aim of the present study to evaluate the influence of different dialysate glucose concentrations (5.5 mmol/L or 11 mmol/L) on blood pressure and glycaemic regulation, using special dialysis equipment - the GENIUS System. This cross-over, prospective and randomised study, total duration 14 weeks, included 20 diabetic patients on maintenance haemodialysis. Group 1: 9 patients dialysed using dialysate with a glucose concentration of 5.5 mmol/L and after 7 weeks switched to dialysate with a glucose concentration of 11 mmol/L. Group 2: vice versa. Results show a statistically higher number of patients with hypoglycaemic and hypotensive episodes using dialysate with a 5.5 mmol/L glucose concentration. Also, mean serum glucose values were higher during haemodialysis sessions with a glucose dialysate concentration of 11 mmol/L. There were no statistical differences between the groups in laboratory values, HbA1C, insulin doses or in anthropometric parameters. Our results suggest that fewer diabetic patients undergoing haemodialysis using a higher dialysate glucose concentration of 11 mmol/L have hypoglycaemic and hypotensive episodes. Since this dialysate glucose concentration had no influence on lipid or hepatic metabolism, anthropometric parameters and especially HbA/1C values in this short-term study, the long term examination of its effects is warranted.
Simic-Ogrizovic
S
S
Clinic of Nephrology, Clinical Center of Serbia, Belgrade,Yugoslavia. dst@Eunet.yu
Backus
G
G
Mayer
A
A
Vienken
J
J
Djukanovic
L
L
Kleophas
W
W
D000368:Aged; D000369:Aged, 80 and over; D001774:Blood Chemical Analysis; D001786:Blood Glucose / Q000032:analysis; D001795:Blood Pressure Determination; D018592:Cross-Over Studies; D003929:Diabetic Neuropathies / Q000628:therapy*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D015312:Hemodialysis Solutions / Q000032:analysis* / Q000737:chemistry; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology* / Q000503:physiopathology; D007022:Hypotension / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D018570:Risk Assessment
D001786:Blood Glucose; D015312:Hemodialysis Solutions; D005947:Glucose