Abstract: FR-PO407
Cardiac Arrhythmia and Hypoglycemia in Patients Receiving Hemodialysis with and without Diabetes (the CADDY study): A Danish Multicenter Cohort Study
Session Information
- Hemodialysis Epidemiology and Outcomes
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Kofod, Dea Haagensen, Rigshospitalet, Kobenhavn, Denmark
- Diederichsen, Søren Zöga, Rigshospitalet, Kobenhavn, Denmark
- Bomholt, Tobias, Rigshospitalet, Kobenhavn, Denmark
- Ørbæk Andersen, Mads, Rigshospitalet, Kobenhavn, Denmark
- Mannheimer, Ebba, Rigshospitalet, Kobenhavn, Denmark
- Rix, Marianne, Rigshospitalet, Kobenhavn, Denmark
- Liem, Ylian Serina, Rigshospitalet, Kobenhavn, Denmark
- Lindhard, Kristine, Herlev Hospital, Herlev, Hovedstaden, Denmark
- Hansen, Henrik Post, Herlev Hospital, Herlev, Hovedstaden, Denmark
- Rydahl, Casper, Herlev Hospital, Herlev, Hovedstaden, Denmark
- Lindhardt, Morten, Holbaek Sygehus, Holbaek, Sjaelland, Denmark
- Schandorff, Kristine D., Nordsjaellands Hospital, Hillerod, Denmark
- Brøsen, Julie Maria Bøggild, Nordsjaellands Hospital, Hillerod, Denmark
- Lange, Theis, Kobenhavns Universitet, Kobenhavn, Denmark
- Noergaard, Kirsten, Steno Diabetes Center Copenhagen, Herlev, Capital Region of Denmark, Denmark
- Almdal, Thomas Peter, Rigshospitalet, Kobenhavn, Denmark
- Svendsen, Jesper Hastrup Hastrup, Rigshospitalet, Kobenhavn, Denmark
- Feldt-Rasmussen, Bo, Rigshospitalet, Kobenhavn, Denmark
- Hornum, Mads, Rigshospitalet, Kobenhavn, Denmark
Background
Patients in hemodialysis (HD) are at increased risk of arrhythmias, and dysregulated blood plasma is proposed as a possible risk factor.
Methods
In an 18-month observational cohort study, 70 patients in maintenance HD treatment (35 with diabetes) were monitored with implantable loop recorders and continuous glucose monitoring (CGM). The primary endpoint was the presence of clinically significant arrhythmias (CSA): a combined endpoint of significant bradyarrhythmia, ventricular tachycardia, or ventricular fibrillation. Logistic regressions adjusted for age and sex were used to examine risk factors of CSA.
Results
A total of 1347 CSA were detected in 23 (33%) patients. Table 1 shows CSA and CGM data. Number of hypoglycemic events, time below range, or time above range were not associated with increased odds for CSA (P>0.05), neither in the overall group nor in the diabetes or no-diabetes groups separately.
Conclusion
Patients in HD have a high risk of CSA, but we found no association between CSA and hypoglycemia or time below or above range.
Arrhythmias and continuous glucose monitoring data
| All (n=70) | Diabetes (n=35) | No diabetes (n=35) | |
| Patients with at least one CSA event | 23 (33) | 12 (34) | 11 (31) |
| Number of CSA events | 1347 | 146 | 1201 |
| Number of CSA events per patient with CSA | 7.0 (2.0-37.5) | 6.5 (3.5-8.3) | 27.0 (1.5-97.0) |
| CSA subtypes | |||
| Patients with at least one bradyarrhythmia event | 18 (26) | 8 (23) | 10 (29) |
| Number of bradyarrhythmia events | 1335 | 135 | 1200 |
| Patients with at least one ventricular tachycardia event | 5 (7) | 4 (11) | 1 (3) |
| Number of ventricular tachycardia events | 12 | 11 | 1 |
| Number of ventricular fibrillation events | 0 | 0 | 0 |
| Continuous glucose monitoring | |||
| Mean sensor glucose (mmol/L) | 11.0 (2.6) | 6.7 (0.6) | |
| % time above range > 10.0 mmol/L | 53.2 (35.1-68.1) | 2.4 (0.9-5.8) | |
| % time in range 3.9-10.0 mmol/L | 44.6 (31.7-64.3) | 93.3 (93.2-97.6) | |
| % time below range < 3.9 mmol/L | 0.5 (0.0-1.1) | 0.6 (0.0-1.2) | |
| Number of hypoglycemic events | 325 | 539 | |
| Patients with at least one hypoglycemic event | 27 (77) | 32 (91) |
Data are presented as mean ± SD, median (interquartile range), or n (%). CSA = clinically significant arrhythmias.
Funding
- Commercial Support – Dexcom, Medtronic