title: Risk of hypoglycemia during hemodialysis in diabetic patients is related to lower pre-dialysis glycemia.
abstract: OBJECTIVE
  To compare the occurrence of hypoglycemia during hemodialysis in chronic kidney disease diabetic patients who present different levels of pre-dialysis glycemia both when using dialysis solutions with and without glucose.
  
  
  METHODS
  Twenty type 2 diabetic patients in maintenance hemodialysis were submitted to three dialysis sessions (at a 7-day interval each) with dialysis solutions without glucose, with glucose at 55 mg/dL, and at 90 mg/dL subsequently. Blood glucose levels were measured immediately pre-dialysis and at 4 moments during the session, and values under 70 mg/dL were considered as hypoglycemia.
  
  
  RESULTS
  Average pre-dialysis glycemia was lower in those who presented intra-dialytic hypoglycemia than in those who did not, both in glucose-free (140.4 ± 50.7 vs. 277.7 ± 91.0 mg/dL; p = 0.005; 95%CI: 46.4 to 228.1) and in glucose 55 mg/dL (89.5 ± 10.6 vs. 229.7 ± 105.0 mg/dL; p < 0.05; 95%CI: 9.8 to 270.5). In patients with pre-dialysis glycemia under 140 mg/dL, average intradialytic glycemia was significantly lower than pre-dialysis glycemia only when using glucose-free dialysate (p < 0.0001; 95%CI: 29.9 to 56.0 - t-test). Hypoglycemia during dialysis was observed only when using glucose-free or glucose-poor dialysis solutions.
  
  
  CONCLUSIONS
  The use of glucose-free or glucose-poor dialysis solution presents a high risk of intradialytic hypoglycemia in diabetic renal patients, especially in those with presumed better glycemic control.
authors.affiliation: Universidade Luterana do Brasil, Canoas, RS, Brazil.
authors.forename: Jayme Eduardo
authors.initials: JE
authors.lastname: Burmeister
authors.affiliation: Universidade Luterana do Brasil, Canoas, RS, Brazil.
authors.forename: Diego da Rosa
authors.initials: Dda R
authors.lastname: Miltersteiner
authors.affiliation: Universidade Luterana do Brasil, Canoas, RS, Brazil.
authors.forename: Bruna Ortega
authors.initials: BO
authors.lastname: Burmeister
authors.affiliation: Universidade Luterana do Brasil, Canoas, RS, Brazil.
authors.forename: Juliana Fernandes
authors.initials: JF
authors.lastname: Campos
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D005260:Female; D005947:Glucose / Q000627:therapeutic use; D015312:Hemodialysis Solutions / Q000737:chemistry*; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy*; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D015312:Hemodialysis Solutions; D005947:Glucose