Glucose control is the key to preventing end-stage renal disease (ESRD) in CKD patients with diabetes. However, managing diabetes in CKD patients can be complicated, as patients’ reduced kidney function can affect how they react to anti-diabetes medications. Difficulties with managing their diabetes can predispose CKD patients to episodes of hypoglycaemia, a condition that can cause severe health complications including dizziness, disorientation, slurred speech, convulsions, and death. The findings of the study indicate that hypoglycaemia may account for some portion of the excess heart-related deaths seen in CKD patients.
The researchers designed a study to examine the incidence of hypoglycaemia among CKD patients and to determine whether the condition might contribute to CKD patients’ deaths. The researchers assessed the incidence of hypoglycaemia in CKD patients relative to non-CKD patients, both with and without diabetes, and they examined the association of hypoglycaemia with subsequent near term deaths (one day after blood glucose measurement).
Analysis included information from 243,222 individuals. The incidence of hypoglycaemia was higher in patients with CKD versus without, both among patients with diabetes and among those without. The risk of hypoglycaemia was highest in individuals with both CKD and diabetes.
Hypoglycaemia increased patients’ risk of dying in the near term. According to the authors, there was a reduced risk of near term death in individuals with CKD relative to those without and this attenuation in the risk of death might relate to an increased quality of care in these patients with CKD relative to diabetic patients without CKD.
"The association of hypoglycaemia with one-day mortality underscores the significance of this metabolic disturbance in patients with diabetes and chronic kidney disease,” said researcher Jeffrey Fink. While details on therapy were not included in this study, the findings are consistent with others that have shown that putting patients on intensive glucose-lowering medications can lead to an increased incidence of hypoglycaemia and does not prolong their survival.
MEDICA.de; Source: American Society of Nephrology (ASN)