Interdialytic weight gain in diabetic haemodialysis patients and diabetic control as assessed by glycated haemoglobin.
BACKGROUND
Cardiovascular morbidity and mortality is increased in diabetic haemodialysis patients. Diabetic subjects may suffer greater thirst and thereby be predisposed to increased interdialytic weight gains and hypertension.


METHODS
175 established adult diabetic haemodialysis patients attending outpatient haemodialysis thrice weekly were audited during a 1-week interval.


RESULTS
Despite fewer patients prescribed antihypertensive medications (46%), the mean pre-dialysis systolic blood pressure was lowest in those patients with the lowest HbA1c values (<or=6%; 146 +/- 27 mm Hg), versus 154 +/- 25 mm Hg for the highest group, with a HbA1c of >8%, of whom 70% were prescribed antihypertensive medications (p < 0.05). Both absolute and percentage interdialytic weight gain was lowest in the group with the best diabetic control: 2.0 +/- 1 kg and 2.76 +/- 1.5% versus 2.5 +/- 1.1 kg and 3.3 +/- 1.3%, respectively (p < 0.05).


CONCLUSIONS
Poor diabetic control may increase thirst and salt intake, leading to increased interdialytic weight gains, associated with systolic hypertension, and as such, diabetic control is an important facet in the management of the diabetic haemodialysis patient.
Davenport
Andrew
A
UCL Center for Nephrology, Royal Free and University College Medical School, London, UK. andrew.davenport@royalfree.nhs.uk
D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy / Q000523:psychology; D003928:Diabetic Nephropathies / Q000097:blood / Q000628:therapy*; D004232:Diuretics / Q000627:therapeutic use; D004327:Drinking Behavior; D004487:Edema / Q000209:etiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000097:blood / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013599:Systole; D013894:Thirst; D015430:Weight Gain
D000959:Antihypertensive Agents; D004232:Diuretics; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin