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Glycemic patterns and factors associated with post-hemodialysis hyperglycemia among end-sStage-renal disease patients undergoing maintenance hemodialysis

Yusof Khan, Abdul Hanif Khan and Zainal Abidin, Muhammad Adil and Zakaria, Nor Fadhlina and Seong Ling, Christopher Tiam and Kamaruddin, Nor Azmi (2020) Glycemic patterns and factors associated with post-hemodialysis hyperglycemia among end-sStage-renal disease patients undergoing maintenance hemodialysis. Journal of the ASEAN Federation of Endocrine Societies (JAFES), 35 (1). pp. 43-51. ISSN 0857-1074 E-ISSN 2308-118x

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Abstract

Introduction. Chronic and post-prandial hyperglycemia are independent risk factors for diabetic complications. Glycemic patterns among hemodialysis end-stage-renal-disease (ESRD) differ as glucose metabolism changes with declining kidney function with more pronounced glycemic fluctuations. The objectives of this study are to determine glycemic patterns on hemodialysis days, the magnitude of post-hemodialysis rebound hyperglycemia (PHH) and their associated factors. Methodology. 148 patients on hemodialysis were analysed, 91 patients had end-stage-diabetic-renal disease (DM-ESRD), and 57 patients had end-stage-non-diabetic renal disease (NDM-ESRD). Glycemic patterns and PHH data were obtained from 11-point and 7-point self-monitoring blood glucose (SMBG) profiles on hemodialysis and non-hemodialysis days. PHH and its associated factors were analysed with logistic regression. Results. Mean blood glucose on hemodialysis days was 9.33 [SD 2.7] mmol/L in DM-ESRD patients compared to 6.07 [SD 0.85] mmol/L in those with NDM-ESRD (p<0.001). PHH occurred in 70% of patients and was more pronounced in DM-ESRD compared to NDM-ESRD patients (72.5% vs 27.5%; OR 4.5). Asymptomatic hypoglycemia was observed in 18% of patients. DM-ESRD, older age, previous IHD, obesity, high HbA1c, elevated highly-sensitive CRP and low albumin were associated with PHH. Conclusion. DM-ESRD patients experienced significant PHH in our cohort. Other associated factors include older age, previous IHD, obesity, high HbA1c, elevated hs-CRP and low albumin.

Item Type: Article (Journal)
Additional Information: 7255/80385
Uncontrolled Keywords: Keywords: renal dialysis, glycemic variability, diabetes complications, hyperglycemia, risk factors
Subjects: R Medicine > RC Internal medicine > RC627 Specialties of Internal Medicine-Metabolic Diseases
R Medicine > RC Internal medicine > RC648 Specialties of Internal Medicine-Diseases of The Endocrine Glands. Clinical Endocrinology
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine > Department of Community Health & Family Medicine
Kulliyyah of Medicine
Depositing User: Dr Muhammad Adil Zainal Abidin
Date Deposited: 14 May 2020 12:48
Last Modified: 14 May 2020 12:48
URI: http://irep.iium.edu.my/id/eprint/80385

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