Kidney Week

Abstract: SA-PO0476

Glucose Time in Range and Cause-Specific Hospitalization in Dialysis

Session Information

• CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Hsu, Simon, University of Washington, Seattle, Washington, United States

Simon Hsu, MD, MS

• Zelnick, Leila R., University of Washington, Seattle, Washington, United States

Leila R. Zelnick, PhD, FASN

• Anderson, Lisa D., University of Washington, Seattle, Washington, United States

Lisa D. Anderson

• Ayers, Ernest, University of Washington, Seattle, Washington, United States

Ernest Ayers

• Bansal, Nisha, University of Washington, Seattle, Washington, United States

Nisha Bansal, MD, FASN

• Hall, Yoshio N., University of Washington, Seattle, Washington, United States

Yoshio N. Hall, MD, MS

• Hirsch, Irl B., University of Washington, Seattle, Washington, United States

Irl B. Hirsch, MD

• Jones, Evelin Noemi, University of Washington, Seattle, Washington, United States

Evelin Noemi Jones

• Liang, Chen, University of Washington, Seattle, Washington, United States

Chen Liang, PhD

• Limonte, Christine P., University of Washington, Seattle, Washington, United States

Christine P. Limonte, MD, MSc

• Tang, Mengyao, Massachusetts General Hospital, Boston, Massachusetts, United States

Mengyao Tang, MD, MPH, FASN

• Trikudanathan, Subbulaxmi, University of Washington, Seattle, Washington, United States

Subbulaxmi Trikudanathan, MD

• de Boer, Ian, University of Washington, Seattle, Washington, United States

Ian de Boer, MD, MS

Background

Hemoglobin A1c is an inaccurate measure of glycemia in kidney failure. Glucose time in range (TIR) ascertained by continuous glucose monitor (CGM) may have clinical utility in risk assessment in this population.

Methods

We performed a prospective cohort study of 420 participants with kidney failure, with or without diabetes, receiving hemodialysis or peritoneal dialysis in the Blood Sugar Sensing on Maintenance Dialysis (BLOSSOM) study. Participants were enrolled from 2021 to 2024 with follow-up through 2024. We ascertained TIR using blinded Dexcom G6 Pro CGMs worn for 10 days in the ambulatory setting. All-cause mortality and hospitalized cardiovascular (CV) and infections were ascertained using hospital discharge diagnosis codes (primary or secondary) from the Washington State Comprehensive Hospital Abstract Reporting System. Associations were tested using Cox regression models.

Results

Mean age was 61 years; 40% were female, 8% were Asian, 16% were Black, and 24% were Hispanic. Among 420 participants, 157 did not have diabetes and 263 had diabetes. Mean (SD) TIR was 52% (30%) among participants with diabetes and 74% (20%) among those without diabetes. Peritoneal dialysis was used by 55 participants. There were 104 deaths, 183 CV events, and 57 hospitalized infections over a median follow-up of 1.5 years. Among participants with diabetes, lower TIR was associated with increased risk of all outcomes, but associations were not statistically significant after adjusting for demographics, cardiovascular risk factors, and medication use (Table 1). Among participants without diabetes, associations were heterogeneous across outcomes.

Conclusion

Among participants with diabetes, TIR may be associated with clinically relevant outcomes in dialysis. Longer follow-up and a larger sample size may allow for more definitive evaluation, and further study is needed to define optimal glycemic metrics in kidney failure.

Funding

• NIDDK Support