Risk of Hypoglycemia during Hemodialysis in Diabetic and Non Diabetic Patients of ESRD: An Observational Study

Mohammad Omar Faruque Miah *

Department of Nephrology, Mymensingh Medical College, Mymensingh, Bangladesh.

Choman Abdullah Mohana

Registrar of Endocrinology, Mymensingh Medical College, Mymensingh, Bangladesh.

Hasanul Islam

Registrar of Nephrology, Mymensingh Medical College, Mymensingh, Bangladesh.

Abu Zafor Md. Salahuddin

Registrar of Nephrology, Mymensingh Medical College, Mymensingh, Bangladesh.

Tasnim Mahmud

Department of Epidemiology, North South University, Bangladesh.

Tarim Mahmood

Department of Maternal and Child Health, National Institute of Preventive and Social Medicine, Bangladesh.

*Author to whom correspondence should be addressed.


Background: Patients with end-stage renal disease (ESRD) regardless of diabetes status are at increased risk of hypoglycemia due to dysregulation of the physiological processes maintaining normal glucose metabolism with a resultant array of adverse clinical outcomes endangering the life of patients.

Objective: The aim of this study is to measure the occurrence of hypoglycemia in patients of ESRD on hemodialysis with or without having diabetes at specified intervals.

Methods: This cross-sectional study will encompass 142 patients with ESRD on dialysis any age group with known ESRD, with or without having diabetes receiving dialysis for >/=3 months. It was be done in dialysis wing, Department of Nephrology of MMCH. The study was occurred from February 2022 to July 2022. Sampling technique was purposive sampling.

Result: Most of the patients (40.8%) were from 46-60 years of age group. In case of gender, male was predominant that was 69.7%. Regarding to diabetes mellitus, majority (80.3%) patients were free from this disease. On the other hand, 62.7% of patients were patient of hypertension. 130 patients had taken dialysis twice per week whereas, only 12 patients had taken dialysis thrice in a week. Most of patients had cardiovascular disease (51.7%) whereas only10.3% patients were affected to diabetic foot. Moreover, most of the patients were found (45.5%) in level 2 hypoglycemia.

Conclusion: Patients were more prone to have level 2 of hyperglycemia in both diabetic and non-diabetic patient. However, the diabetic patient had more chance of co-morbidities along with complications.

Keywords: ESRD, glucose metabolism, insulin sensitivity, kidney disease

How to Cite

Miah , Mohammad Omar Faruque, Choman Abdullah Mohana, Hasanul Islam, Abu Zafor Md. Salahuddin, Tasnim Mahmud, and Tarim Mahmood. 2024. “Risk of Hypoglycemia During Hemodialysis in Diabetic and Non Diabetic Patients of ESRD: An Observational Study”. Asian Journal of Research in Nephrology 7 (1):58-63. https://journalajrn.com/index.php/AJRN/article/view/77.


Download data is not yet available.


Akmal M. Hemodialysis in diabetic patients. American Journal of Kidney Diseases. 2001 Oct 1;38(4):S195-9.

Kovesdy CP, Park JC, Kalantar‐Zadeh K. Glycemic control and burnt‐out diabetes in ESRD. In Seminars in Dialysis. Oxford, UK: Blackwell Publishing Ltd. 2010 Mar; 23(2):148-156).

Ferrannini E, Wahren JO, Faber OK, Felig PH, Binder CH, De Fronzo RA. Splanchnic and renal metabolism of insulin in human subjects: A dose-response study. American Journal of Physiology-endocrinology and Metabolism. 1983 Jun 1;244(6):E517-27.

Orskov H, Hansen AP, Hansen HE, Alberti KG, Noy GA, Nosadini R. Acetate: Inhibitor of growth hormone hypersecretion in diabetic and non-diabetic uraemic subjects. Acta Endocrinologica. 1982 Apr 1;99(4):551-8.

Jackson MA, Holland MR, Nicholas J, Talbot M, Spencer H, Lodwick R, Fuhrmann C, Forster D, Macdonald IA. Occult hypoglycemia caused by hemodialysis. Clinical Nephrology. 1999 Apr 1;51(4):242-7.

Jackson, MA, Holland, MR, Nicholas, J, Lodwick, R, Foster, D, Macdonald IA. Hemodialysis-induced hypoglycemia in diabetic patients. Clin Nephrol. 2000;54: 30-4.

Yu TM, Lin CL, Chang SN, Sung FC, Kao CH. Increased risk of stroke in patients with chronic kidney disease after recurrent hypoglycemia. Neurology. 2014 Aug 19;83(8):686-94.

Seaquist ER, Anderson J, Childs B, Cryer P, Dagogo-Jack S, Fish L, Heller SR, Rodriguez H, Rosenzweig J, Vigersky R. Hypoglycemia and diabetes: A report of a workgroup of the American Diabetes Association and the Endocrine Society. The Journal of Clinical Endocrinology & Metabolism. 2013 May 1;98(5):1845-59.

Collins AJ, Foley RN, Herzog C, Chavers BM, Gilbertson D, Ishani A, Kasiske BL, Liu J, Mau LW, McBean M, Murray A. Excerpts from the US renal data system 2009 annual data report. American Journal of Kidney Diseases. 2010 Jan 1;55(1):A6-7.

Ricks J, Molnar MZ, Kovesdy CP, Shah A, Nissenson AR, Williams M, Kalantar-Zadeh K. Glycemic control and cardiovascular mortality in hemodialysis patients with diabetes: A 6-year cohort study. Diabetes. 2012 Mar 1;61(3):708-15.

Aidar FJ, de Oliveira RJ, de Matos DG, Mazini Filho ML, Moreira OC, de Oliveira CE, Hickner RC, Reis VM. A randomized trial investigating the influence of strength training on quality of life in ischemic stroke. Topics in Stroke Rehabilitation. 2016 Feb 17;23(2):84-9.

Field JB. Hypoglycemia: definition, clinical presentations, classification, and laboratory tests. Endocrinology and Metabolism Clinics of North America. 1989 Mar 1;18(1):27-43.

Haviv YS, Sharkia M, Safadi R. Hypoglycemia in patients with renal failure. Renal Failure. 2000 Jan 1;22(2):219-23.

Weigert A, Drozdz M, Silva F, Frazao J, Alsuwaida A, Krishnan M, Kleophas W, Brzosko S, Johansson FK, Jacobson SH. Influence of gender and age on haemodialysis practices: A European multicentre analysis. Clinical Kidney Journal. 2020 Apr;13(2):217-24.

Stack AG, Bloembergen WE. Prevalence and clinical correlates of coronary artery disease among new dialysis patients in the United States: A cross-sectional study. Journal of the American Society of Nephrology. 2001 Jul 1;12(7):1516-23.

Gianchandani RY, Neupane S, Heung M. Hypoglycemia in hospitalized hemodialysis patients with diabetes: An observational study. Journal of Diabetes Science and Technology. 2018 Jan;12(1):33-8.

Burmeister JE, Miltersteiner DD, Burmeister BO, Campos JF. Risk of hypoglycemia during hemodialysis in diabetic patients is related to lower pre-dialysis glycemia. Archives of Endocrinology and Metabolism. 2015; 59:137-40.