The effect of hemodialysis on glycemic variability
 
More details
Hide details
1
Oddział Neurochirurgii, Szpital Wojewódzki w Bielsku-Białej
 
2
Centrum Medyczne MEDEA w Mazańcowicach, Poradnia Podstawowej Opieki Zdrowotnej
 
3
Klinika Chorób Wewnętrznych, Diabetologii i Nefrologii, Wydział Lekarski z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach Katowicach
 
 
Corresponding author
Grzegorz Tadeusz Pruś   

Oddział Neurochirurgii, Szpital Wojewódzki w Bielsku-Białej, al. Armii Krajowej 101, 43-300 Bielsko-Biała
 
 
Ann. Acad. Med. Siles. 2019;73:53-59
 
KEYWORDS
TOPICS
ABSTRACT
The steady increase in the incidence of type 2 diabetes, which is the leading cause of end-stage renal failure among hemodialysis patients, has been the subject of multidisciplinary research. Much attention has been devoted to the effects of hemodialysis on blood glucose fluctuations during hemodialysis and intervals between treatments, as well as differences in glycemic variability in patients with and without diabetes mellitus. A large group of studies is those related to methods of monitoring glucose levels and the usefulness of individual biomarkers. The results clearly show the significant and different effects of hemodialysis on glycemic dysfunction in people with and without diabetes. It has also been shown that due to the numerous interfering factors, the usefulness of HbA1c to monitor glucose levels in hemodialysis patients is lower compared to non-demyelised individuals, but still remains the primary biomarker for glucose monitoring. Research has also become a method of treating diabetes in hemodialysis patients, dietary recommendations and an attempt to develop standards for the care of hemodialysis patients. The results of individual studies on obesity and dietary recommendation remain unchanged, suggesting a positive effect on the quality of life, renal failure, and hemodialysis itself. These results have not yet been confirmed by subsequent studies.
 
REFERENCES (79)
1.
Snyder J.J., Foley R.N., Collins A.J. Prevalence of CKD in the United States: a sensitivity analysis using the National Health and Nutrition Examination Survey (NHANES) 1999–2004. Am. J. Kidney Dis. 2009; 53(2): 218–228, doi: 10.1053/j.ajkd.2008.07.034.
 
2.
Coresh J., Astor B.C., Greene T., Eknoyan G., Levey A.S. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am. J. Kidney Dis. 2003; 41(1): 1–12, doi: 10.1053/ajkd.2003.50007.
 
3.
U.S. Renal Data System, USRDS 2005 Annual Data Report: Atlas of EndStage Renal Disease in the United States, National Institutes of Health, National Institutes of Diabetes and Digestive and Kidney Diseases. Bethesda, MD, 2005.
 
4.
Obrador G.T., Pereira B.J., Kausz A.T. Chronic kidney disease in the United States: an underrecognized problem. Semin. Nephrol. 2002; 22(6): 441–448.
 
5.
Adler A.I., Stevens R.J., Manley S.E., Bilous R.W., Cull C.A., Holman R.R. Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int. 2003; 63(1): 225–232.
 
6.
American Diabetes Association. Prevention or delay of type 2 diabetes. Diabetes Care 2015: 38 (Suppl. 1): S31–S32.
 
7.
Bailey R.A., Wang Y., Zhu V., Rupnow M.F. Chronic kidney disease in US adults with type 2 diabetes: an updated national estimate of prevalence based on Kidney Disease: Improving Global Outcomes (KDIGO) staging. BMC Res. Notes 2014; 7: 415, doi: 10.1186/1756-0500-7-415.
 
8.
K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am. J. Kidney Dis. 2002; 39(2 Suppl. 1): S1–S266.
 
9.
Sit D., Kadiroglu A.K., Kayabasi H., Yilmaz M.E. The prevalence of insulin resistance in nondiabetic nonobese patients with chronic kidney disease. Adv. Ther. 2006; 23(6): 988–998.
 
10.
Niemczyk S., Szamotulska K., Giers K., Jasik M., Bartoszewicz Z., Rmejko-Ciepielewska K., Paklerska E., Gomółka M., Matuszkiewicz-Rowińska J. Homeostatic model assessment indices in evaluation of insulin resistance and secretion in hemodialysis patients. Med. Sci. Monit. 2013; 19: 592–598, doi: 10.12659/MSM.883978.
 
11.
Sharma K., Considine R.V., Michael B., Dunn S.R., Weisberg L.S., Kurnik B.R., Kurnik P.B., O‘Connor J., Sinha M., Caro J.F. Plasma leptin is partly cleared by the kidney and is elevated in hemodialysis patients. Kidney Int. 1997; 51(6): 1980–1985.
 
12.
Sudha M.J.,  Salam H.S., Viveka S., Udupa A.L. Assessment of changes in insulin requirement in patients of type 2 diabetes mellitus on maintenance hemodialysis. J. Nat. Sci. Biol. Med. 2017; 8(1): 64–68, doi: 10.4103/0976-9668.198348.
 
13.
Eldin W.S., Ragheb A., Klassen J., Shoker A. Evidence for increased risk of prediabetes in the uremic patient. Nephron Clin. Pract. 2008; 108(1): c47–c55.
 
14.
King H., Aubert R.E., Herman W.H. Global Burden of Diabetes, 1995–2025: prevalance, numerial estimates, and projections. Diabetes Care 1998; 21(9): 1414–1431.
 
15.
Breyer J.A. Diabetic nephropathy in insulin-dependent patients. Am. J. Kidney Dis. 1992; 20(6): 533–547.
 
16.
Ritz E., Stefański A. Diabetic nephropathy in type 2 diabetes. Am. J. Kidney Dis. 1996; 27(2): 167–194.
 
17.
UK Renal Registry. 2014 – The Seventeenth Annual Report [online], https://www.renalreg.org/repor... [Dostęp: 02.2016].
 
18.
United States Renal Data System. 2012 Atlas of CKD & ESRD [online], http://www.usrds.org/atlas12.a... [Dostęp: 02.2016].
 
19.
Coresh J., Selvin E., Stevens L.A., Manzi J., Kusek J.W., Eggers P., Van Lente F., Levey A.S. Prevalence of chronic kidney disease in the United States. JAMA 2007; 298(17): 2038–2047.
 
20.
U.S. Renal Data System, USRDS 1997 Annual Data Report. National Institutes of Health, National Institutes of Diabetes and Digestive and Kindey Diseases. Bethesda, MD, 1997.
 
21.
U.S. Renal Data System, USRDS 2000 Annual Data Report. National Institutes of Health, National Institutes of Diabetes and Digestive and Kindey Diseases. Bethesda, MD, 2000.
 
22.
Ritz E., Rychlík I. Diabetic nephropathy – the size of the problem. W: Diabetic nephropathy. Red. C. Hasslacher. John Wiley & Sons. Nowy Jork 2000, s. 3–18.
 
23.
Kikkawa R., Kida Y., Haneda M. Nephropathy in type 2 diabetes – epidemiological issues as viewed from Japan. Nephrol. Dial. Transplant. 1998; 13(11): 2743–2745.
 
24.
Ritz E., Fliser D. Nephropathy in NIDDM – an update. W: Diabetic renal-retinal syndrome. Red. E.A. Friedman, F.A. L’Esperance Jr. Kluwer Academic. Dordrecht 1998, s. 27–39.
 
25.
Kokoszka-Paszkot J., Grzeszczak W., Paszkot M. Ocena wyrównania metabolicznego chorych na cukrzycę typu 2 leczonych sanatoryjnie w Wysowej-Zdroju w świetle kryteriów European Diabetes Policy Group i American Diabetes Association. Doniesienie wstępne. Diabetol. Dośw. Klin. 2002; 2: 309–313.
 
26.
Hasslacher C., Borgholte G., Panradl U., Wahl P. Verbesserte Prognoze von type 1 und type 2 diabetikern mit nephropatie. Med. Klein. 1990; 85(11): 643–646.
 
27.
Sułowicz W. Zaawansowana nefropatia cukrzycowa. W: Przewlekłe powikłania cukrzycy. Red. J. Sieracki. Fundacja Rozwoju Diagnostyki Laboratoryjnej. Kraków 1995, s. 55–74.
 
28.
Maurer Z.M., Fioretto P., Woredekal Y., Friedman E.A. Diabetic nephropathy. W: Diseases of the Kidney and Urinary Tract. Red. R.W. Schrier. Lippincott Williams & Wilkins. Philadelphia 2001, s. 2083–2127.
 
29.
Rutkowski B., Lichodziejewska-Niemierko M., Grenda R. i wsp. Raport o stanie leczenia nerkozastępczego w Polsce w 2006 r. Gdańsk 2008.
 
30.
Rutkowski B., Lichodziejewska-Niemierko M., Grenda R. i wsp. Raport o stanie leczenia nerkozastępczego w Polsce w 2008 r. Gdańsk 2011.
 
31.
Hasslacher C. Natural course of diabetic nephropathy. W: Diabetic nephropathy. Red. C. Hasslacher. John Wiley & Sons. Nowy Jork 2001, s. 19–37.
 
32.
Akmal M. Hemodialysis in diabetic patients. Am. J. Kidney Dis. 2001; 38(4 Suppl. 1): S195–S199.
 
33.
McMillan M.A., Briggs J.D., Junor B.J. Outcome of renal replacement treatment in patients with diabetes mellitus. Br. Med. J. 1990; 301(6751): 540–544.
 
34.
Harmankaya O., Akalin N., Akay H., Okuturlar Y., Erturk K., Kaptanogullari H., Kocoglu H. Comparison of risk factors for cardiovascular disease in hemodialysis and peritoneal dialysis patients. Clinics (Sao Paulo) 2015; 70(9): 601–605, doi: 10.6061/clinics/2015(09)01.
 
35.
Daugirdas J.T. Pathophysiology of dialysis hypotension: an update. Am. J. Kidney Dis. 2001; 38(4 Suppl. 4): S11–S17.
 
36.
Sanai T., Tada H., Ono T., Fukumitsu T. Changes of the glycemic control and therapeutic regimen for diabetes mellitus in the Japanese patients on hemodialysis. Diabetes Metab. Syndr. 2015; 9(4): 244–246, doi: 10.1016/j.dsx.2015.02.012.
 
37.
Zilker T.R., Rebel C., Kopp K.F., Wahl K., Ermler R., Heinzel G., Hales C.N., Bottermann P. Kinetics of biosynthetic human proinsulin in patients with terminal renal insufficiency. Horm. Metab. Res. Suppl. 1988; 18: 43–48.
 
38.
Yildiz A., Hursit M., Celik A.V., Kayacan S.M., Yazici H., Akkaya V., Gürol A.O., Karsidag K. Doxazosin, but not amlodipine decreases insulin resistance in patients with chronic renal failure: a prospective, randomized-controlled study. Clin. Nephrol. 2002; 58(6): 405–410.
 
39.
Little R.R., Tennill A.L., Rohlfing C., Wiedmeyer H.M., Khanna R., Goel S., Agrawal A., Madsen R., Goldstein D.E. Can glycohemoglobin be used to assess glycemic control in patients with chronic renal failure? Clin. Chem. 2002; 48(5): 784–786.
 
40.
Marshall J., Jennings P., Scott A., Fluck R.J., McIntyre C.W. Glycemic control in diabetic CAPD patients assessed by continuous glucose monitoring system (CGMS). Kidney Int. 2003; 64(4): 1480–1486.
 
41.
Rave K., Heise T., Pfützner A., Heinemann L., Sawicki P.T. Impact of diabetic nephropathy on pharmacodynamics and pharmacokinetic properties of insulin in type 1 diabetic patients. Diabetes Care 2001; 24(5): 886–890.
 
42.
Atherton G. Renal replacement and diabetes care: the role of a specialist nurse. J. Diabetes Nurs. 2004; 8: 70–72.
 
43.
Chaturvedi N., Fuller J.H. Glycosylated hemoglobin and the risk of microalbuminuria in insulin-dependent diabetes mellitus. EURODIAB IDDM Complications Study Group. N. Engl. J. Med. 1995; 333(14): 940–941.
 
44.
Gaede P., Vedel P., Larsen N., Jensen G.V.H., Parving H.H., Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N. Engl. J. Med. 2003; 348(5): 383–393.
 
45.
Mácsai E., Rakk E., Miléder M., Fulcz A. Significance of hemoglobin A1C in the management of diabetes in dialysis patients. Orv. Hetil. 2014; 155(36): 1421–1425, doi: 10.1556/OH.2014.29986.
 
46.
Shima K., Chujo K., Yamada M., Komatsu M., Noma Y., Mizuguchi T. Lower value of glycated haemoglobin relative to glycaemic control in diabetic patients with end-stage renal disease not on haemodialysis. Ann. Clin. Biochem. 2012; 49(Pt 1): 68–74, doi: 10.1258/acb.2011.011161.
 
47.
Ansari A., Goldsmith D., Krimholtz M. i wsp. Measuring glycaemic control in renal failure. Diabet. Med. 2001; 18: 70A (abstract).
 
48.
Gunton J.E., McElduff A. Hemoglobinopathies and HbA(1c) measurement. Diabetes Care 2000; 23(8): 1197–1198.
 
49.
Herman W.H., Cohen R.M. Racial and ethnic differences in the relationship between HbA1c and blood glucose: implications for the diagnosis of diabetes. J. Clin. Endocrinol. Metab. 2012; 97(4): 1067–1072, doi: 10.1210/jc.2011-1894.
 
50.
Uzu T., Hatta T., Deji N., Izumiya T., Ueda H., Miyazawa I., Kanasaki M., Isshiki K., Nishio T., Arimura T. Target for glycemic control in type 2 diabetic patients on hemodialysis: effects of anemia and erythropoietin injection on hemoglobin A(1c). Ther. Apher. Dial. 2009; 13(2): 89–94, doi: 10.1111/j.1744-9987.2009.00661.x.
 
51.
Riveline J.P., Teynie J., Belmouaz S., Franc S., Dardari D., Bauwens M., Caudwell V., Ragot S., Bridoux F., Charpentier G., Marechaud R., Hadjadj S. Glycaemic control in type 2 diabetic patients on chronic haemodialysis: use of a continuous glucose monitoring system. Nephrol. Dial. Transplant. 2009; 24(9): 2866–2871, doi: 10.1093/ndt/gfp181.
 
52.
Sobngwi E., Ashuntantang G., Ndounia E., Dehayem M.Y. Continuous interstitial glucose monitoring in non-diabetic subjects with end-stage renal disease undergoing maintenance haemodialysis. Diabetes Res. Clin. Pract. 2010; 90(1): 22–25.
 
53.
Jung H.S., Kim H.I., Kim M.J., Yoon J.W., Kim M.J., Yoon J.W., Ahn H.Y., Cho Y.M., Oh K.H., Joo K.W., Lee J.G., Kim S.Y., Park K.S. Analysis of hemodialysis-associated hypoglycemia in patients with type 2 diabetes using a continuous glucose monitoring system. Diabetes Technol. Ther. 2010; 12(10): 801–807, doi: 10.1089/dia.2010.0067.
 
54.
Firlej-Pruś M., Grzeszczak W. Wpływ hemodializy na stężenie glukozy w płynie pozakomórkowym u chorych ze schyłkową niewydolnością nerek w przebiegu lub bez cukrzycy. Ann. Acad. Med. Siles. 2012; 66(6): 13–26.
 
55.
Holman R.R., Paul S.K., Bethel M.A., Matthews D.R., Neil H.A. 10-year follow-up of intensive glucose control in type 2 diabetes. N. Engl. J. Med. 2008; 359(15): 1577–1589, doi: 10.1056/NEJMoa0806470.
 
56.
Nathan D.M., Cleary P.A., Backlund J.Y., Genuth S.M., Lachin J.M., Orchard T.J., Raskin P., Zinman B. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N. Engl. J. Med. 2005; 353(25): 2643–2653.
 
57.
The Action to Control Cardiovascular Risk in Diabetes Study Group. Gerstein H.C., Miller M.E., Byington R.P., Goff D.C. Jr, Bigger J.T., Buse J.B., Cushman W.C., Genuth S., Ismail-Beigi F., Grimm R.H. Jr, Probstfield J.L., Simons-Morton D.G., Friedewald W.T. Effects of intensive glucose lowering in type 2 diabetes. N. Engl. J. Med. 2008; 358(24): 2545–2559, doi: 10.1056/NEJMoa0802743.
 
58.
Park J., Lertdumrongluk P., Molnar M.Z., Kovesdy C.P., Kalantar-Zadeh K. Glycemic control in diabetic dialysis patients and the burnt-out diabetes phenomenon. Curr. Diab. Rep. 2012; 12(4): 432–439, doi: 10.1007/s11892-012-0286-3.
 
59.
Fonseca V.A., Alvarado-Ruiz R., Raccah D., Boka G., Miossec P., Gerich J.E. Efficacy and safety of the once-daily GLP-1 receptor agonist lixisenatide in monotherapy: a randomized, double-blind, placebo-controlled trial in patients with type 2 diabetes (GetGoal-Mono). Diabetes Care 2012; 35(6): 1225–1231, doi: 10.2337/dc11-1935.
 
60.
Bouchi R., Babazono T., Onuki T., Mitamura K., Ishikawa Y., Uchigata Y., Iwamoto Y. Administration of insulin glargine thrice weekly by medical staff at a dialysis unit: a new insulin regimen for diabetic management in physically impaired patients undergoing hemodialysis. Diabetol. Int. 2011; 2: 197–201.
 
61.
Shoji T., Emoto M., Mori K., Morioka T., Fukumoto S., Takahashi T., Matsumoto A., Nishizawa Y., Inaba M. Thrice-weekly insulin injection with nurse’s support for diabetic hemodialysis patients having difficulty with self injection. Osaka City Med. J. 2012; 58(1): 35–38.
 
62.
Willingham F. The dietary management of patients with diabetes and renal disease: challenges and practicalities. J. Ren. Care 2012; 38(Suppl. 1): 40–51, doi: 10.1111/j.1755-6686.2012.00283.x.
 
63.
Stolic R. Obesity in renal failure – health or disease? Med. Hypotheses 2010; 75(6): 497–500, doi: 10.1016/j.mehy.2010.07.004.
 
64.
Chazot C., Gassia J.P., Benedetto A., Cesare S., Ponce P., Marcelli D. Is there any survival advantage of obesity in southern European haemodialysis patients? Nephrol. Dial. Transplant. 2009; 24(9): 2871–2876, doi: 10.1093/ndt/gfp168.
 
65.
Burmeister J.E., Scapini A., da Rosa Miltersteiner D., da Costa M.G., Campos B.M. Glucose-added dialysis fluid prevents asymptomatic hypoglycaemia in regular haemodialysis. Nephrol. Dial. Transplant. 2007; 22(4): 1184–1189.
 
66.
Abe M., Okada K., Ikeda K., Matsumoto S., Soma M., Matsumoto K. Characterization of insulin adsorption behavior of dialyzer membranes used in hemodialysis. Artif. Organs 2011; 35(4): 398–403, doi: 10.1111/j.1525-1594.2010.01112.x.
 
67.
Abe M., Kikuchi K., Matsumoto K. The influence of hemodialysis membranes on the plasma insulin level of diabetic patients on maintenance hemodialysis. Clin. Nephrol. 2008; 69(5): 354–360.
 
68.
de Moraes T.P., Fortes P.C., Ribeiro S.C., Riella M.C., Pecoits-Filho R. Comparative analysis of lipid and glucose metabolism biomarkers in non-diabetic hemodialysis and peritoneal dialysis patients. J. Bras. Nefrol. 2011; 33(2): 173–179.
 
69.
Abe M., Okada K., Maruyama T., Maruyama N., Matsumoto K., Soma M. Relationship between erythropoietin responsiveness, insulin resistance, and malnutrition-inflammation-atherosclerosis (MIA) syndrome in hemodialysis patients with diabetes. Int. J. Artif. Organs 2011; 34(1): 16–25.
 
70.
Hung A.M., Ikizler T.A. Factors determining insulin resistance in chronic hemodialysis patients. Contrib. Nephrol. 2011; 171: 127–134, doi: 10.1159/000327177.
 
71.
Elias A.N., Vaziri N.D., Maksy M. Plasma norepinephrine, epinephrine, and dopamine levels in end-stage renal disease. Effect of hemodialysis. Arch. Intern. Med. 1985; 145(6): 1013–1015.
 
72.
Kohli S., Batra P., Aggarwal H.K. Anxiety, locus of control, and coping strategies among end-stage renal disease patients undergoing maintenance hemodialysis. Indian J. Nephrol. 2011; 21(3): 177–181, doi: 10.4103/0971-4065.83729.
 
73.
Kobayashi S., Maejima S., Ikeda T., Nagase M. Impact of dialysis therapy on insulin resistance in end-stage renal disease: comparison of haemodialysis and continuous ambulatory peritoneal dialysis. Nephrol. Dial. Transplant. 2000; 15(1): 65–70.
 
74.
da Costa J.A., Ikizler T.A. Inflammation and insulin resistance as novel mechanisms of wasting in chronic dialysis patients. Semin. Dial. 2009; 22(6): 652–657.
 
75.
Boulton A.J., Malik R.A., Arezzo J.C., Sosenko J.M. Diabetic somatic neuropathies. Diabetes Care 2004; 27(6): 1458–1486.
 
76.
Mambelli E., Barrella M., Facchini M.G., Mancini E., Sicuso C., Bainotti S., Formica M., Santoro A.  The prevalence of peripheral neuropathy in hemodialysis patients. Clin. Nephrol. 2012; 77(6): 468–475.
 
77.
Jackson M.A., Holland M.R., Nicholas J., Lodwick R., Forster D., MacDonald I.A. Hemodialysis-induced hypoglycemia in diabetic patients. Clin. Nephrol. 2000; 54(1): 30–34.
 
78.
de Boer I.H., Mehrotra R. Insulin resistance in chronic kidney disease: a step closer to effective evaluation and treatment. Kidney Int. 2014; 86(2): 243–245, doi: 10.1038/ki.2014.123.
 
79.
Guarnieri G., Zanetti M., Vinci P., Cattin M.R., Barazzoni R. Insulin resistance in chronic uremia. J. Ren. Nutr. 2009; 19(1): 20–24, doi: 10.1053/j.jrn.2008.11.014.
 
eISSN:1734-025X
Journals System - logo
Scroll to top