Blood Glucose Profile in Nigerian Chronic Renal Patients on Haemodialysis

Abstract

Glucose derangements are recognized features of end-stage renal disease. Hypoglycaemia,  when encountered in patients with chronic renal failure carries a poor prognosis. This study was designed to assess the magnitude of hypoglycaemia in chronic renal failure patients on haemodialysis. Twenty non-diabetic chronic renal failure patients on haemodialysis with glucose-free bicarbonate dialysate were studied. Body mass index and serum albumin were recorded. Venous blood glucose was assessed before commencement of haemodialysis and hourly for 4 hours during dialysis.

Twelve of the initial study group had blood glucose estimation on a day they were not undergoing dialysis. Blood glucose levels of <3.9mmol/l was regarded as hypoglycaemia and <2.5mmol/l as severe hypoglycaemia. Blood glucose of subjects in the dialysis and post-dialysis period were globally but hypoglycaemia was more prevalent during dialysis. In the haemodialysis period, blood glucose was <3.9mmol/L in 85% and <2.5mmoll in 50% of subjects. Blood glucose decreased with increasing duration of haemodialysis. Symptoms of hypoglycaemia were uncommon and only encountered in 15% of subjects.

Malnutrition was prevalent in the study population. Chronic renal failure patients have low levels of blood glucose and during haemodialysis, they commonly develop hypoglycaemia which in most cases, passes unnoticed. Malnutrition may be a contributory factor to the development of hypoglycaemia in subjects studied. We advocate the use of glucose-containing dialysate fluids for haemodialysis in non-diabetic chronic renal failure patients. Glucose drinks during haemodialysis may also be of help. Adequate nutrition should also be encouraged in patients with chronic renal failure.