Interdialytic weight gain correlates with glycosylated hemoglobin in diabetic hemodialysis patients

Most of the excess mortality and morbidity in diabetic end-stage renal disease patients is ascribed to diabetes-associated cardiovascular disease, which is accelerated by uremia. We compared the interdialytic weight gain in 33 diabetic patients (group 1) undergoing maintenance hemodialysis in an ambulatory facility retrospectively over 3 months, with 25 randomly selected nondiabetic hemodialysis patients (group 2); in addition, we assessed glycemic control in the diabetic subjects using glycosylated hemoglobin (HbA1c). Interdialytic weight gain was expressed as a percentage of the immediately preceding postdialysis weight, and a mean was calculated for each subject. In all subjects, predialysis serum aldosterone, plasma renin activity, and the interdialytic change in serum sodium were measured. Both groups received an equivalent amount of dialysis using a cellulose membrane (mean +/- SD of thrice weekly dialysis: group 1 = 3.8 +/- 0.35 hours, group 2 = 3.86 +/- 0.3 hours; P < 0.5) and had similar predialysis serum creatinine, hematocrit, and serum albumin levels. Group 1 patients had a mean age of 56.5 +/- 11.4 years (age range, 30 to 71 years) and group 2 had a mean age of 55.8 +/- 15.4 years (age range, 29 to 76 years) (P < 0.84). Mean (+/- SD) duration on maintenance hemodialysis was 18.7 +/- 15.3 months (range, 2 to 84 months) for group 1 and 21 +/- 28.9 months (range, 3 to 156 months) for group 2 (P < 0.9). Interdialytic weight gain was 30% greater in group 1 (4.2% +/- 0.19%) than in group 2 (3.2% +/- 0.2%) (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)