Kidney Week

Abstract: FR-PO468

Glycemia Assessed by Continuous Glucose Monitoring among Patients on Dialysis

Session Information

• Home Dialysis - 1
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

• Mayeda, Laura, University of Washington, Seattle, Washington, United States

Laura Mayeda, MD, MPH

• Zelnick, Leila R., University of Washington, Seattle, Washington, United States

Leila R. Zelnick, PhD

• Trikudanathan, Subbulaxmi, University of Washington, Seattle, Washington, United States

Subbulaxmi Trikudanathan, MD

• Hirsch, Irl B., University of Washington, Seattle, Washington, United States

Irl B. Hirsch, MD

• Ashford, Nathaniel, University of Washington, Seattle, Washington, United States

Nathaniel Ashford

• Hall, Yoshio N., University of Washington, Seattle, Washington, United States

Yoshio N. Hall, MD, MS

• De Boer, Ian, University of Washington, Seattle, Washington, United States

Ian De Boer, MD, MS

Background

In kidney failure, patients are at risk for hypo- and hyperglycemia due to impaired insulin sensitivity, insulin secretion, and kidney gluconeogenesis. Little is known about glycemia patterns in dialysis patients and HbA1c is biased in kidney failure and does not reflect fluctuations in blood glucose.

Methods

The Blood Sugar Sensing On Maintenance Dialysis (BLOSSOM) study is a prospective community-based cohort of people treated with dialysis, with or without diabetes mellitus (DM), designed to assess the prevalence, causes, and consequences of dysglycemia using continuous glucose monitoring (CGM). Participant wore a Dexcom G6Pro CGM for 10 days. This interim analysis of the first 373 BLOSSOM participants.

Results

Participants had a mean (SD) age of 61 (14) years. We enrolled 231 participants with DM (including 81 HD patients no longer treated with glucose-lowering drugs) and 142 without DM. Mean CGM blood glucose was high and time in range (TIR) was low (below 70% clinical target in diabetes) for participants with DM, regardless of dialysis modality (Table). PD participants without DM also had low TIR (Table). Hyperglycemia increased throughout the day and was the highest in participants with treated DM on PD (Figure). Hypoglycemia was common for HD patients with or without DM (Table).

Conclusion

In this community-based sample of maintenance dialysis patients, uncontrolled hyperglycemia was highly prevalent, especially among participants with DM and PD participants without DM, and hypoglycemia was frequent.

Table. Glycemia metrics assessed using continuous glucose monitoring, by dialysis modality and diabetes status

Figure. Continuous glucose monitoring data by dialysis modality and diabetes status

Funding

• NIDDK Support