Frequent hypoglycemia during hemodialysis in ESRD patients leads to higher risk of death.

Abstract

Objective: With the increase of patients with end-stage renal disease (ESRD), most of are receiving hemodialysis, hypoglycemia is a frequent occurrence in ESRD patients due to alterations in glucose and insulin metabolism. The purpose of our study was to explore the correlation between hypoglycemia and long-term survival in patients with ESRD during hemodialysis.

Methods: Using the database of Hemodialysis Center in Taizhou Second People's Hospital, 268 ESRD patients undergoing maintenance hemodialysis (MHD) for more than 3 months between January 1, 2019 and September 30, 2023 were enrolled. Basic information, laboratory tests and treatment conditions of patients were collected. We analyzed the impact of hypoglycemia during hemodialysis on survival rate, and explored whether hypoglycemia is an independent risk factor for mortality in MHD patients.

Results: We found that factors such as BMI, smoking, and alcohol consumption didn't affect survival rate in ESRD patients, while all-cause mortality was higher in ESRD patients with diabetes, cardiovascular diseases, cerebrovascular disease and experienced hypoglycemia during hemodialysis (p < 0.05). We also observed that almost all ESRD patients with diabetes experienced hypoglycemia during dialysis, and 87.5% experienced ≥3 times, while this phenomenon was hardly observed in nondiabetic ESRD patients. Cox proportional hazards model analysis found that, frequent hypoglycemia (≥3 times) was associated with higher mortality risk in ESRD patients (p = 0.041), adjusted hazard ratios (95% confidence intervals) 3.998 (2.462-6.492).

Conclusions: Occurrence of hypoglycemia during dialysis was associated with a higher risk of death, frequent hypoglycemia (≥3 times) was an independent risk factor for death in MHD patients.