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Changes of Hemodynamic Parameters after Intradialytic Glucose Injection

Longin Niemczyk1, Katarzyna Romejko2, Katarzyna Szamotulska3

  • 1Department of Nephrology, Dialysis and Internal Diseases, Medical University of Warsaw, 1a Banacha Street, 02-097 Warsaw, Poland.

Nutrients
|January 21, 2023
PubMed

Insights

Glucose infusions during hemodialysis (HD) effectively prevent intradialytic hypotension (IDH) without causing severe hypertension. This study demonstrates a novel approach to managing a common complication in chronic kidney disease patients undergoing HD.

Area of Science:

  • Nephrology
  • Cardiovascular Physiology

Background:

  • Intradialytic hypotension (IDH) is a common and challenging complication during hemodialysis (HD).
  • Existing strategies for preventing IDH are often insufficient, necessitating novel therapeutic approaches.

Purpose of the Study:

  • To investigate the efficacy of intravenous glucose infusion in preventing symptomatic IDH during HD.
  • To analyze the hemodynamic effects of glucose administration on blood pressure and heart rate in chronic kidney disease (CKD) patients.

Main Methods:

  • A prospective study involving 35 CKD patients undergoing HD.
  • Administration of a 40% glucose solution (0.5 g/kg dry weight) 30 minutes into HD.
  • Continuous monitoring of systolic (SBP), diastolic (DBP), mean arterial pressure (MAP), pulse pressure (PP), and heart rate (HR).
  • Assessment of relative volume overload using bioimpedance spectroscopy.

Main Results:

  • Glucose infusion led to significant increases in SBP, DBP, MAP, and PP at various time points during HD.
  • Observed interactions between hemodynamic parameters and baseline heart rate, as well as fluid overload.
  • Crucially, no symptomatic hypotensive episodes were recorded in participants receiving glucose infusions.

Conclusions:

  • Intravenous glucose administration during HD is an effective method for preventing symptomatic intradialytic hypotension.
  • This intervention does not appear to precipitate severe hypertensive episodes, offering a safe alternative for IDH management.
Abstract

Keywords:
arterial blood pressurechronic kidney diseaseclinical experimentheart ratehemodialysishypotension

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