Changes in blood glucose and lactate concentrations with hemodialysis

Introduction Blood glucose concentrations are recognized to vary during hemodialysis (HD), with hypoglycemia reported with glucose‐free dialysates. As glucose can be converted to lactate, and conversely lactate to glucose, we wished to study factors associated with peri‐dialytic changes in blood glucose. Methods We prospectively collected data including patient profile, dialysis prescription, hemodynamic parameters, medications, dialysis adequacy and monthly blood tests for three consecutive months. All patients used a 100 mg/dl glucose dialysate. Linear mixed model, general estimated equation and binary logistic regression were used for analysis. Results We studied 157 sessions in 55 patients, median age 67.1 (58.5–72.6) years, 67% male, 71% diabetic, 40% prescribed insulin, dialysis vintage 20.4 (10.7–57.7) months. Mean single pool Kt/Vurea and normalized protein nitrogen appearance rate (nPNA) were 1.70 ± 0.34 and 1.01 ± 0.30 g/kg/day respectively. Hypoglycemia (