Low blood sugar may be hazardous for patients with kidney disease
POSTED May 9, 2009 - 13:27 | POSTED BY Neharika Sabharwal
Last edited by Harpreet Bhagrath on May 9, 2009 - 14:42
Link between CKD and diabetes
Monitoring of glucose levels is vital in preventing end stage renal disease (ESRD) in CKD with diabetics. CKD patients with diabetes face serious complications because their impaired kidney function may react adversely to diabetic medications.
These complications may lead to incidents of hypoglycemia, which are linked to dizziness, disorientation, slurred speech, convulsions or death.
Details of the study
Jeffrey C. Fink, MD (University of Maryland Medical System), Maureen F. Moen (University of Maryland School of Medicine), and their colleagues formulated a study to establish if the prevalence of hypoglycemia in CKD patients was a major contributing factor of death.
A retrospective study was conducted of 243,222 patients cared for at the Veterans Health Administration. The researchers evaluated the occurrence of hypoglycemia in patients with either CKD, diabetes, both or neither. They also analyzed the connection of hypoglycemia with subsequent near term deaths (one day after blood glucose measurement).
From the analysis, the researchers gathered that the incidence of hypoglycemia was higher in patients with CKD, both with or without diabetes. The risk of hypoglycemia was highest in individuals with both CKD and diabetes.
The researchers observed that relatively mild hypoglycemia, with blood glucose readings from 60 to 69 mg/dL, increased short-term mortality by 85 percent compared with non hypoglycemic patients.
According to the researchers, hypoglycemia increased patients' risk of dying in the near term. The findings revealed that administrating intensive glucose-lowering medicines can lead to an increased incidence of hypoglycemia and prove fatal for the patient.
An interesting finding
A perplexing find was a reduced risk of near term death in individuals with CKD compared to those without the problem.
The researchers assumed that patients with kidney disease may receive closer attention and monitoring and hence may manage to fend off death longer.
"The association of hypoglycemia with one-day mortality underscores the significance of this metabolic disturbance in patients with diabetes and chronic kidney disease," said Dr. Fink.
The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the American Society of Nephrology.
The study will appear in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN).
