[Effect of different levels of glucose in the dialysate on the risk of hypoglycaemia during hemodialysis in diabetic patients].

Abstract

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. We tested a dialytic fluid with a lower level of glucose trying to prevent both hypo and hyperglycemia in these patients. 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. 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. 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.