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Abstract: FR-PO556

Glucose (Glu) Disposal in Diabetic (D) and Non-Diabetic (ND) Patients During Hemodialysis (HD)

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Niemczyk, Longin, Medical University of Warsaw, Warszawa, Poland
  • Niemczyk, Stanislaw, Military Medical Institute of Warsaw, Warsaw, Poland
  • Wojtecka, Anna, Military Medical Institute of Warsaw, Warsaw, Poland
  • Szamotulska, Katarzyna, National Research Institute of Mother and Child, Warsaw, Poland
  • Schneditz, Daniel, Medical University of Graz, Graz, Austria
Background

It was the purpose to examine whether intra-venous (iv) Glu administered during HD caused a characteristic response suitable to detect impaired Glu tolerance in HD patients (pts) during routine treatment.

Methods

About 30 min into treatment (baseline T0), a 40% Glu solution (100.1±22.0 mL) was directly injected into the venous line of the extracorporeal circulation at a dose of 0.5 g/kg dry weight. Blood samples were drawn from the arterial line at T0, and 5, 10, 20, 30, 60 min after injection (T5, T10, T20, T30, T60). Glu (mmol/L) and insulin (Ins; mU/L) levels were measured. In addition, relative blood volume (RBV; %) was continuously measured by ultrasonic technique for quantification of osmotic volume effects.

Results

25 ND and 9 D pts were studied (61±13 years, dry weight 80.6±17.6 kg, UF volume 2.47±0.92 L, 12 female). The increase and time course in Glu was largely comparable between D and ND pts; Ins significantly increased in ND pts only (Tab. 1). The RBV effect of Glu peaked around 6 min after injection and was 105.16±1.30 vs. 105.90±1.52% in ND and D pts, respectively, and also showed a comparable time course (Fig. 1).

Conclusion

In spite of significant difference in Ins secretion, infusion of Glu amount comparable to that of an iv Glu tolerance test did not produce major differences in Glu disposal during HD. It appears that Glu is removed faster by HD than it can be disposed in the large but slowly perfused Ins-dependent muscle and skin compartment. This may have implications for iv nutrition during extracorporeal treatments.

Tab. 1
  T0T5T10T20T30T60
GluND5.2±0.624.6±3.818.5±2.413.7±1.811.0±1.57.4±1.1
D7.5±2.4*25.4±3.819.5±3.416.2±3.313.7±3.310.7±2.8*
InsND10.1±7.3101.2±49.367.8±36.750.3±33.737.9±28.621.3±23.7
D8.0±3.514.2±7.6*13.3±7.2*15.5±8.9*14.0±7.9*11.0±6.0*

* p<0.05 ND vs. D

Fig. 1

Funding

  • Clinical Revenue Support