Efeito de diferentes níveis de glicose no dialisato sobre o risco de hipoglicemia durante hemodiálise em pacientes diabéticos

introduction: hypoglycemia can occur during hemodialysis in diabetic chronic renal failure patients when using a dialysate without glucose. with dialysis solutions with glucose 90 mg/dl or more, this is preventable, but diabetic patients could present higher intradialytic glycemias. objective: we tested a dialytic fluid with a lower level of glucose trying to prevent both hypo and hyperglycemia in these patients. methods: twenty diabetic individuals from our hemodialysis unit were submitted to 3 sessions with dialysis solutions with two different glucose concentrations - 55 mg/dl (phase 55), and 90 mg/dl (phase 90) - and a glucose-free one (phase zero). plasma glucose levels were measured at five moments during each session - before and at 30, 60, 90 and 240 min. results under 70 mg/dl were considered as hypoglycemia. results: three patients presented 6 episodes of hypoglycemia in phase 55, but no patient presented any episode in phase 90. in phase zero, five patients presented 7 episodes. conclusion: this dialysate with a low level of glucose (55 mg/dl) did not prevent hypoglycemia episodes during hemodialysis in diabetic patients, these occurrences being similar to that when using a dialysate without glucose. the use of a 90 mg/dl glucose dialysis solution did not induce higher intradialytic glycemia levels than the other dialysis solutions.