Postprandial intradialytic dysglycaemia and diabetes in maintenance haemodialysis patients.
BACKGROUND
Although the risk of developing dysglycaemia has been investigated in different communities this incidence is poorly studied in patients on maintenance haemodialysis (MHD).


METHODS
In a multicentre observational cohort study the occurrence of dysglycaemia was assessed in 239 primary normoglycaemic end stage renal disease (ERSD) patients on MHD. Dysglycaemia (fasting blood glucose > 110 mg dL(-1), > 140 mg dL(-1) 2 h after food intake) or diabetes (fasting blood glucose > 126 mg dL(-1) or > 200 mg dL(-1) at any time) were defined according to WHO criteria and cases were compared with age matched controls within the cohort.


RESULTS
Dysglycaemia was found in 82 primary normoglycaemic ESRD patients (34%) within 31 months after initiation of MHD. In 31 of these patients type 2 diabetes was diagnosed. When compared with matched control MHD patients differences in body mass index (BMI), HbA1c and postprandial blood glucose were detectable (P < 0.05). Increments in 0.1% of HbA1c were related with 11% higher odds for dysglycaemia (P = 0.002). In a subgroup of 36 primary normoglycaemic MHD patients who developed dysglycaemia event-free survival was 64%, 53%, 31%, 17% and 11% after 1, 2, 3, 4 and 5 years of haemodialysis treatment.


CONCLUSIONS
Onset of dysglycaemia or diabetes is frequent in ESRD patients after onset of chronic haemodialysis. Routine measurement of blood glucose before and after haemodialysis should be implemented as a standard of care during MHD.
Medical University of Vienna, Division of Nephrology and Dialysis, Vienna, Austria.
D G
DG
Haider
H
H
Fuhrmann
J
J
Kovarik
S
S
Heiss
H
H
Graf
M
M
Auinger
F
F
Mittermayer
M
M
Wolzt
W H
WH
Hörl
D000368:Aged; D015415:Biomarkers / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood / Q000209:etiology* / Q000401:mortality; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D006435:Renal Dialysis; D018709:Statistics, Nonparametric
D015415:Biomarkers; D006442:Glycated Hemoglobin