Changes of Hemodynamic Parameters after Intradialytic Glucose Injection

Abstract

Background: Intradialytic hypotension (IDH) is a frequent complication of hemodialysis (HD). Current methods of IDH prevention are insufficient. Methods: We analyzed the intradialytic time course of systolic (SBP), diastolic (DBP), mean arterial (MAP), pulse pressure (PP), and heart rate (HR) in a group of chronic kidney disease (CKD) patients. First, 30 min into HD, a 40% glucose solution was injected into the venous line of the extracorporeal circulation at a dose of 0.5 g/kg of dry weight. Pressures and HR were measured in frequent intervals. Relative volume overload was determined by bioimpedance spectroscopy. Results: Thirty-five participants were studied. SBP increased after 5, 10, and 20 min of glucose infusion. DBP increased after 2 and 3 h and also at the end of HD. PP increased after 5, 10, and 20 min of glucose infusion and fell after the 2nd and 3rd hour and also at the end of HD. MAP increased after 2 and 3 h of glucose injection and at the end of HD. Significant interactions of the time course of SBP, DBP, MAP, with HR at baseline and of the time course of PP with fluid overload were observed. Symptomatic hypotensive episodes were absent. Conclusions: Glucose infusions during HD prevent symptomatic IDH and do not cause severe hypertensive episodes.

Comparable Hemodilution with Hypertonic Glucose in Patients with and without Type-2 Diabetes Mellitus during Hemodialysis

“…The increase in pulse pressure in this study is also indicative of increased stroke volume ( Figure 3 ). A more detailed analysis of the hemodynamic effects of hypertonic glucose is presented in the companion publications of the same journal [ 27 , 28 ].…”

Cardiovascular Response to Intravenous Glucose Injection during Hemodialysis with Assessment of Entropy Alterations

“…This is the continuation of a study performed in a group of CKD patients with (DM) and without type-2 diabetes mellitus (NDO) treated with hemodialysis in the Dialysis Department of the Military Institute of Medicine in Warsaw, Poland, reported previously [17,18]. More information about material and methods is found in these publications and in companion papers of this study [19,20].…”