Hypoglycemia Increases Mortality Risk in CKD Patients on Hemodialysis

Chronic kidney disease (CKD) patients undergoing hemodialysis frequently experience hypoglycemia with potential life-threatening consequences. A new study published in Journal of Renal Nutrition uncovered predictors and highlighted the risks associated with hypoglycemia during the first year of dialysis treatment.

In a study of 58,304 incident hemodialysis patients under the care of a national dialysis organization from 2007 to 2011, clinical experts examined factors contributing to the occurrence of hypoglycemia and its implications, including mortality risk. Hypoglycemia was defined as a blood glucose concentration below 70 mg/dL.

During the first year of dialysis, 16.8% of diabetic patients and 6.9% of non-diabetic patients experienced hypoglycemia. This suggests that hypoglycemia is a widespread issue in the hemodialysis population.

The study revealed that several clinical characteristics were associated with a higher risk of hypoglycemia, including younger age, female gender, African-American race, the presence of a central venous catheter, lower residual renal function, and longer dialysis session length. These insights could help medical professionals identify high-risk individuals and implement preventive measures.

Importantly, hypoglycemia was linked to a significant increase in the risk of all-cause mortality in the overall patient cohort. Patients who experienced hypoglycemia during the first year of dialysis had a mortality risk 1.08 times higher compared to those who did not experience low blood sugar. Subgroup analyses further revealed this trend held true for both diabetic and non-diabetic patients.

These findings emphasize the importance of addressing and hypoglycemia prevention in patients undergoing hemodialysis, as it not only poses immediate health risks but also contributes to long-term mortality. The study's authors suggest the need for further research to develop strategies for reducing the occurrence of hypoglycemia in the hemodialysis population. Understanding the risk factors and implications of hypoglycemia is a crucial step toward improving the care and outcomes of patients with chronic kidney disease, particularly those receiving hemodialysis.

Source:

Kang, D.-H., Streja, E., You, A. S., Lee, Y., Narasaki, Y., Torres, S., Novoa, A., Kovesdy, C. P., Kalantar-Zadeh, K., & Rhee, C. M. (2023). Hypoglycemia and Mortality Risk in Incident Hemodialysis Patients. In Journal of Renal Nutrition. Elsevier BV. https://doi.org/10.1053/j.jrn.2023.09.001