Talk Description
411 - Research Paper
Abstract
Aim:
To determine the rate of out-of-range post-haemodialysis blood glucose levels, the rate of out-of-range post-haemodialysis blood glucose levels that are clinically acted upon, the type of intervention and outcome of each intervention, and the associations between post-haemodialysis blood glucose levels and relevant clinical predictors.
Method:
We conducted a 12-month retrospective cohort medical record review in one Australian haemodialysis centre. Post-haemodialysis blood glucose levels, pre-haemodialysis blood glucose levels, time of treatment, diabetes medications, intradialytic fluid removal, dialysate dextrose concentration, clinical actions, interventions, and outcomes on out-of-range blood glucose levels were retrieved.
Results:
1703 haemodialysis sessions were analysed from 22 participants aged 67 + 12 years, with a median time receiving dialysis 3.1 years (IQR 2.3-4.7). The proportion of out-of-range post-haemodialysis blood glucose levels was estimated to be 87.3% (95% CI, 86.1% to 88.5%). No out-of-range post-haemodialysis blood glucose levels were clinically acted upon and there were no intervention episodes or outcomes of these interventions in the study sample. Out-of-range post-haemodialysis blood glucose levels were 4.6 times more likely if a 2g/l compared to a 1g/l dextrose bath was used (95% CI:3.3; 6.3. p<0.001). The odds of the post- haemodialysis blood glucose levels being out-of-range increased by 34% as the pre-haemodialysis blood glucose levels increased by each 1 mmol/L. Intradialytic fluid removal, dialysate dextrose concentration, sex, dialysis time, anti-hyperglycaemic agents were also associated with out-of-range post-haemodialysis blood glucose levels.
Conclusion:
Routine post-haemodialysis blood glucose levels testing has limited clinical utility in the routine care for people with diabetes receiving haemodialysis. Higher dextrose dialysate may require individual titration depending on pre- and post-haemodialysis blood glucose levels.
Abstract
Aim:
To determine the rate of out-of-range post-haemodialysis blood glucose levels, the rate of out-of-range post-haemodialysis blood glucose levels that are clinically acted upon, the type of intervention and outcome of each intervention, and the associations between post-haemodialysis blood glucose levels and relevant clinical predictors.
Method:
We conducted a 12-month retrospective cohort medical record review in one Australian haemodialysis centre. Post-haemodialysis blood glucose levels, pre-haemodialysis blood glucose levels, time of treatment, diabetes medications, intradialytic fluid removal, dialysate dextrose concentration, clinical actions, interventions, and outcomes on out-of-range blood glucose levels were retrieved.
Results:
1703 haemodialysis sessions were analysed from 22 participants aged 67 + 12 years, with a median time receiving dialysis 3.1 years (IQR 2.3-4.7). The proportion of out-of-range post-haemodialysis blood glucose levels was estimated to be 87.3% (95% CI, 86.1% to 88.5%). No out-of-range post-haemodialysis blood glucose levels were clinically acted upon and there were no intervention episodes or outcomes of these interventions in the study sample. Out-of-range post-haemodialysis blood glucose levels were 4.6 times more likely if a 2g/l compared to a 1g/l dextrose bath was used (95% CI:3.3; 6.3. p<0.001). The odds of the post- haemodialysis blood glucose levels being out-of-range increased by 34% as the pre-haemodialysis blood glucose levels increased by each 1 mmol/L. Intradialytic fluid removal, dialysate dextrose concentration, sex, dialysis time, anti-hyperglycaemic agents were also associated with out-of-range post-haemodialysis blood glucose levels.
Conclusion:
Routine post-haemodialysis blood glucose levels testing has limited clinical utility in the routine care for people with diabetes receiving haemodialysis. Higher dextrose dialysate may require individual titration depending on pre- and post-haemodialysis blood glucose levels.