Last update:
13-Jul-2004

OBJECTIVE Disturbances of carbohydrate metabolism are common in chronic hemodialysis patients and predispose to spontaneous hypoglycemia. The aim of the study was the estimation of the incidence and severity of hypoglycemia in non-diabetic, chronic hemodialysis patients during hemodialysis with glucose-free dialysate.

METHOD We studied 49 chronic hemodialysis, non diabetic patients (27 males, 22 females), 54.9±15.2 years of age and on hemodialysis for 45±25 months. All patients had a well-functioning arteriovenous fistula or graft, had Ht >=32%, did not suffer from coronary or other serious vascular disease and received no drugs that could influence carbohydrate metabolism or hypoglycemia perception. All sessions were performed with low-flux dialyzers. Blood sugar was measured at 0, 15, 30, 45, 60, 90, 120, 150, 180 and 240 minutes and serum insulin at hourly intervals. We also estimated Body Mass Index (BMI). Blood glucose was measured with oxidase-based reaction and serum insulin with a radioimmunoassay (RIA) method.

RESULTS Hypoglycemia (blood sugar <60 mg/dL) was observed in 17 patients (34.7%), 9 males-8 females. In 3 patients, hypoglycemia was severe and symptomatic and study was discontinued. In the rest 14 patients, hypoglycemia was mild and asymptomatic. At all measurements, correlations between serum insulin-blood sugar, BMI-serum insulin and BMI-blood sugar were positive and statistically significant.

CONCLUSIONS In the chronic hemodialysis, non-diabetic patients of our study, hypoglycemia was common during hemodialysis session with glucose-free dialysate and, mainly, asymptomatic.

Key words: Glucose-free dialysate, Hemodialysis, Hypoglycemia.