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Hypoglycemia in nondiabetic patients undergoing albumin dialysis by molecular adsorbent recirculating system

Ai-Leng Khoo1, Lai-San Tham, Gek-Kee Lim

  • 1Departments of Pharmacy, National University Hospital, National University of Singapore, Singapore. khooal@nuh.com.sg

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
|August 28, 2003
PubMed

Insights

Molecular adsorbent recycling system (MARS) treatment can cause hypoglycemia. Replacing glucose at approximately 6 g/h during MARS dialysis prevents hypoglycemia in non-diabetic patients.

Area of Science:

  • Nephrology
  • Hepatology
  • Endocrinology

Background:

  • Molecular Adsorbent Recycling System (MARS) is used for liver failure treatment.
  • Hypoglycemia has been observed during MARS treatment.
  • Lack of clear dextrose replacement guidelines during MARS dialysis.

Purpose of the Study:

  • To assess the effect of MARS treatment on blood glucose concentration.
  • To determine glucose removal rates during MARS dialysis.
  • To formulate dextrose replacement guidelines to prevent hypoglycemia.

Main Methods:

  • Five non-diabetic patients with liver failure underwent 6-8 hour MARS treatments.
  • Blood glucose was monitored hourly.
  • Glucose loss in dialysate was quantified hourly.

Main Results:

  • Mean glucose removal during a 6-hour MARS session was 37.19 ± 5.58 g (6.20 ± 0.93 g/h).
  • Patients experienced hypoglycemia without appropriate dextrose replacement.
  • Dextrose replacement at a mean rate of 6 g/h (range, 5-7 g/h) prevented hypoglycemia.

Conclusions:

  • MARS treatment leads to significant glucose removal.
  • A dextrose replacement rate of 6 g/h is recommended during MARS dialysis for non-diabetic patients.
  • Implementing these guidelines can prevent hypoglycemia and improve patient outcomes.

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