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Kidney Week

Abstract: SA-PO457

Accuracy of Real-Time Continuous Glucose Monitoring in Hemodialysis Patients with Diabetes

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Narasaki, Yoko, University of California Irvine School of Medicine, Irvine, California, United States
  • Kalantar-Zadeh, Kamyar, Harbor-UCLA Medical Center, Torrance, California, United States
  • You, Seungsook, University of California Irvine School of Medicine, Irvine, California, United States
  • Daza Aguilar, Andrea C., University of California Irvine School of Medicine, Irvine, California, United States
  • Novoa-Vargas, Alejandra, University of California Irvine School of Medicine, Irvine, California, United States
  • Nguyen, Danh V., University of California Irvine School of Medicine, Irvine, California, United States
  • Rhee, Connie, University of California Irvine School of Medicine, Irvine, California, United States
Background

HD patients with diabetes are at heightened risk of hypo- and hyperglycemia. Traditional glycemic markers (HbA1c) are less reliable in ESKD, and self-monitored blood glucose may not adequately capture glycemic status in HD patients given its infrequent nature. We thus sought to assess the accuracy of continuous glucose monitoring (CGM) as a more frequent (every 5-minutes), convenient, and automated method of glycemic assessment in a prospective HD cohort with diabetes.

Methods

Among 33 HD patients with diabetes hospitalized from 10/2020-5/2021, we conducted simultaneous glucose measurements using CGM measured by Dexcom G6 devices vs. blood glucose levels using capillary fingerstick or venous blood glucose, with the latter measured at least 4 times per day (before each meal and at night), plus every 30 minutes while receiving HD (total of 6-8 measures during HD). We assessed the agreement of CGM vs. blood glucose values using the mean absolute relative difference (MARD), defined as the average of absolute values of relative differences between CGM vs. blood glucose).

Results

The MARD was 19% overall and 18% and 22% during the non-HD and HD periods, respectively. Consensus error grid analysis showed all of sensor values in clinically acceptable zones A (allowable total error region typically associated with no harm) and B (small amount of data slightly outside the no harm zone but unlikely to cause significant harm).

Conclusion

In hospitalized HD patients with diabetes with concurrent CGM and blood glucose measurements, real-time CGM showed clinically acceptable performance and agreement with blood glucose. Further studies are needed to determine whether CGM can improve the glycemic management of HD patients compared to conventional approaches.

Funding

  • Commercial Support – Dexcom