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The effect of glucose added to the dialysis fluid on blood pressure, blood glucose, and quality of life in hemodialysis patients: a placebo-controlled crossover study.
Am J Kidney Dis. 2006 Apr; 47(4):636-43.AJ

Abstract

BACKGROUND

Risk for hypoglycemia increases during hemodialysis sessions. The compensatory homeostatic response to hypoglycemia may increase the risk for abnormal blood pressure regulation. The purpose is to determine blood pressure and blood glucose levels and variability in these variables during dialysis with and without glucose in the dialysis fluid.

METHODS

In a randomized, placebo-controlled, unblinded, crossover study of 44 hemodialysis patients, 34 patients without diabetes and 10 patients with diabetes were allocated to treatment with and without glucose in the dialysis fluid during two 10-week periods. Blood pressure and blood glucose levels were determined 5 to 8 times at each dialysis session during both periods. Quality of life was estimated by using the 36-Item Short-Form Health Survey questionnaire at the end of both treatment periods.

RESULTS

With glucose in the dialysis fluid, blood pressure was significantly lower (systolic, 144 +/- 20 versus 149 +/- 21 mm Hg; P < 0.003; diastolic, 73 +/- 10 versus 76 +/- 10 mm Hg; P < 0.001), blood glucose level was higher (125 +/- 25 versus 110 +/- 26 mg/dL [6.96 +/- 1.36 versus 6.08 +/- 1.47 mmol/L]; P < 0.001), and quality of life was the same. Variations in systolic and diastolic blood pressures and blood glucose levels were the same during both treatments. In the subgroup of patients with diabetes, variation in blood glucose levels decreased significantly with glucose in the dialysis fluid (mean, 30 versus 37 mg/dL [1.66 versus 2.03 mmol/L]; P = 0.008).

CONCLUSION

Systolic and diastolic blood pressures decreased with glucose in the dialysis fluid in patients with chronic renal failure, presumably because of insulin-induced vasodilatation in patients without diabetes. Blood glucose level regulation improved in the diabetic subgroup, and blood glucose levels were not greater in patients with diabetes with glucose in the dialysis water. Quality of life was not changed.

Authors+Show Affiliations

Department of Medical Research, Holstebro Hospital, Aarhus University, Holstebro, Denmark.No affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16564941

Citation

Sangill, Maren, and Erling B. Pedersen. "The Effect of Glucose Added to the Dialysis Fluid On Blood Pressure, Blood Glucose, and Quality of Life in Hemodialysis Patients: a Placebo-controlled Crossover Study." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 47, no. 4, 2006, pp. 636-43.
Sangill M, Pedersen EB. The effect of glucose added to the dialysis fluid on blood pressure, blood glucose, and quality of life in hemodialysis patients: a placebo-controlled crossover study. Am J Kidney Dis. 2006;47(4):636-43.
Sangill, M., & Pedersen, E. B. (2006). The effect of glucose added to the dialysis fluid on blood pressure, blood glucose, and quality of life in hemodialysis patients: a placebo-controlled crossover study. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 47(4), 636-43.
Sangill M, Pedersen EB. The Effect of Glucose Added to the Dialysis Fluid On Blood Pressure, Blood Glucose, and Quality of Life in Hemodialysis Patients: a Placebo-controlled Crossover Study. Am J Kidney Dis. 2006;47(4):636-43. PubMed PMID: 16564941.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of glucose added to the dialysis fluid on blood pressure, blood glucose, and quality of life in hemodialysis patients: a placebo-controlled crossover study. AU - Sangill,Maren, AU - Pedersen,Erling B, PY - 2005/11/04/received PY - 2006/01/10/accepted PY - 2006/3/28/pubmed PY - 2006/5/24/medline PY - 2006/3/28/entrez SP - 636 EP - 43 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 47 IS - 4 N2 - BACKGROUND: Risk for hypoglycemia increases during hemodialysis sessions. The compensatory homeostatic response to hypoglycemia may increase the risk for abnormal blood pressure regulation. The purpose is to determine blood pressure and blood glucose levels and variability in these variables during dialysis with and without glucose in the dialysis fluid. METHODS: In a randomized, placebo-controlled, unblinded, crossover study of 44 hemodialysis patients, 34 patients without diabetes and 10 patients with diabetes were allocated to treatment with and without glucose in the dialysis fluid during two 10-week periods. Blood pressure and blood glucose levels were determined 5 to 8 times at each dialysis session during both periods. Quality of life was estimated by using the 36-Item Short-Form Health Survey questionnaire at the end of both treatment periods. RESULTS: With glucose in the dialysis fluid, blood pressure was significantly lower (systolic, 144 +/- 20 versus 149 +/- 21 mm Hg; P < 0.003; diastolic, 73 +/- 10 versus 76 +/- 10 mm Hg; P < 0.001), blood glucose level was higher (125 +/- 25 versus 110 +/- 26 mg/dL [6.96 +/- 1.36 versus 6.08 +/- 1.47 mmol/L]; P < 0.001), and quality of life was the same. Variations in systolic and diastolic blood pressures and blood glucose levels were the same during both treatments. In the subgroup of patients with diabetes, variation in blood glucose levels decreased significantly with glucose in the dialysis fluid (mean, 30 versus 37 mg/dL [1.66 versus 2.03 mmol/L]; P = 0.008). CONCLUSION: Systolic and diastolic blood pressures decreased with glucose in the dialysis fluid in patients with chronic renal failure, presumably because of insulin-induced vasodilatation in patients without diabetes. Blood glucose level regulation improved in the diabetic subgroup, and blood glucose levels were not greater in patients with diabetes with glucose in the dialysis water. Quality of life was not changed. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/16564941/The_effect_of_glucose_added_to_the_dialysis_fluid_on_blood_pressure_blood_glucose_and_quality_of_life_in_hemodialysis_patients:_a_placebo_controlled_crossover_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(06)00069-2 DB - PRIME DP - Unbound Medicine ER -