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Chinese Journal of Blood Purification ›› 2007, Vol. 6 ›› Issue (6) : 314-316.

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Abstract

Objective To investigate the suitable dialysate glucose concentration and its clinical significance in hemodialysis patients with end-stage diabetic nephropathy. Methods Forty-two patients with end-stage diabetic nephropathy were randomly divided into three groups, to which dialysate containing glucose 0 mmol/L (control group), 4.5 mmol/L (group I) and 6.0 mmol/L (group II), respectively, was used during hemodialysis. Blood glucose was determined every hour for 3 hours after the beginning of the hemodialysis. Subsequently, dialysate containing 6.0 mmol/L glucose was used to all patients, serum fructosamine (FA) was measured before and after the dialysis, and blood glucose was determined 2 hours after the dialysis. Patients were then divided into two groups: group A, FA >2.2 mmol/L and group B, FA＜2.2 mmol/L. Results (a) In the 416 hemodialyses, the rate of hypoglycemia within the 3 hours was higher in control group and group I than in group II (P＜0.05), but had no difference between control group and group I. (b) In the 3 groups, the rate of hypoglycemia was higher after the dialysis for 2-3 hours as compared with that after one hour (P＜0.01), but had no difference after the dialysis for 2-3 hours. (c) With regard to group A and B, the rate of hypoglycemia was higher in group B after the dialysis for 2 hours (P＜0.01). (d) No change of FA was found in these patients before and after the dialysis. Conclusions (a) The rate of hypoglycemia was higher in patients using dialysates containing 0-4.5 mmol/L glucose than in those using dialysate of 6 mmol/L glucose. (b) Hypoglycemia during hemodialysis is frequently seen in patients with lower FA. (c) FA can not be cleaned up by hemodialysis.