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Kidney Week

Abstract: FR-PO0458

Glucose Assessment During Hemodiafiltration: Comparison Between Continuous Monitor, Finger Capillary, and Dialysis Line Glucose

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Carvalho, Marcia S, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Kojima, Christiane, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Rocha, Érica Pires da, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Costa, Daniel Monte, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Magalhães, Andréa Olivares, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Borges, Cynthia Moura, Splendore Kidney Care, Sao Paulo, Brazil
  • Rocha, Eduarda, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Fernandes, Andreia, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Resende, Larissa, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Quilelli, Amanda L, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Alves, Luciane, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Cuppari, Lilian, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Elias, Rosilene M., Nefrostar Kidney Care, Sao Paulo, Brazil
Background

Diabetic kidney disease is the leading cause of end-stage kidney disease worldwide. Glycemic control can be difficult to achieve in patients on dialysis. Currently, the evaluation of the glycemic profile relies on serum markers, capillary blood glucose control (self-monitoring of blood glucose), and interstitial glucose monitoring (continuous glucose monitoring, CGM). However, the latter has not yet been well established in this population due to the influence of dialysis on interstitial fluid. Our objective was to evaluate the capillary, interstitial and dialysis system line glycemia.

Methods

This is a cross-sectional analysis of glucose monitoring in adult patients with diabetes on hemodiafiltration. We simultaneously assessed glucose levels using CGM, finger capillary sampling, and dialysis line measurements (before, 1 and 2 hours after session). The concentration of glucose in the dialysis solution was identical for all patients. The results were compared using repeated measures ANOVA.

Results

A total of 22 patients, 68.2% men, 66 glucose measurements were included. Blood glucose values obtained from CGM, finger capillary sampling, and dialysis line before dialysis were 138±55, 156±74, and 150±9 mg/dL (p=0.014); after 1 hour were 117±30, 142±38, and 133±36 mg/dL (p<0.01); and after 2 hours were 141±52, 163±56, and 153±58 mg/dL (p<0.01), respectively. Glucose levels obtained from CGM were lower in all comparisons, with no difference between finger capillary sampling, and dialysis line. The Bland-Altman plot revealed ower values from CGM compared to finger capillary sampling (Fig.1A) or dialysis line (Fig.1B).

Conclusion

CGM can be a useful tool for patients on hemodiafiltration, although it tends to yield lower readings than finger capillary sampling or dialysis line measurements. The latter two methods show comparable results and can be used interchangeably.

Digital Object Identifier (DOI)