Frequent hypoglycemia during hemodialysis in ESRD patients leads to higher risk of death

Objective With the increase of patients with end-stage renal disease (ESRD), most of are receiving hemodialysis, hypoglycemia is a frequent occurrence in ESRD patients due to alterations in glucose and insulin metabolism. The purpose of our study was to explore the correlation between hypoglycemia a...

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Main Authors: Yuwen Shi, Tao Wang, Zhihui Ding, Lijuan Yan, Chunlei Yao, Hua Qian
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2025.2484471
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author Yuwen Shi
Tao Wang
Zhihui Ding
Lijuan Yan
Chunlei Yao
Hua Qian
author_facet Yuwen Shi
Tao Wang
Zhihui Ding
Lijuan Yan
Chunlei Yao
Hua Qian
author_sort Yuwen Shi
collection DOAJ
description Objective With the increase of patients with end-stage renal disease (ESRD), most of are receiving hemodialysis, hypoglycemia is a frequent occurrence in ESRD patients due to alterations in glucose and insulin metabolism. The purpose of our study was to explore the correlation between hypoglycemia and long-term survival in patients with ESRD during hemodialysis.Methods Using the database of Hemodialysis Center in Taizhou Second People’s Hospital, 268 ESRD patients undergoing maintenance hemodialysis (MHD) for more than 3 months between January 1, 2019 and September 30, 2023 were enrolled. Basic information, laboratory tests and treatment conditions of patients were collected. We analyzed the impact of hypoglycemia during hemodialysis on survival rate, and explored whether hypoglycemia is an independent risk factor for mortality in MHD patients.Results We found that factors such as BMI, smoking, and alcohol consumption didn’t affect survival rate in ESRD patients, while all-cause mortality was higher in ESRD patients with diabetes, cardiovascular diseases, cerebrovascular disease and experienced hypoglycemia during hemodialysis (p < 0.05). We also observed that almost all ESRD patients with diabetes experienced hypoglycemia during dialysis, and 87.5% experienced ≥3 times, while this phenomenon was hardly observed in nondiabetic ESRD patients. Cox proportional hazards model analysis found that, frequent hypoglycemia (≥3 times) was associated with higher mortality risk in ESRD patients (p = 0.041), adjusted hazard ratios (95% confidence intervals) 3.998 (2.462–6.492).Conclusions Occurrence of hypoglycemia during dialysis was associated with a higher risk of death, frequent hypoglycemia (≥3 times) was an independent risk factor for death in MHD patients.
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spelling doaj-art-8c9f9418403c4da5a2d85ea5d293ad962025-08-20T03:13:26ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2484471Frequent hypoglycemia during hemodialysis in ESRD patients leads to higher risk of deathYuwen Shi0Tao Wang1Zhihui Ding2Lijuan Yan3Chunlei Yao4Hua Qian5Department of Endocrinology, The Affiliated Taizhou Second People’s Hospital of Yangzhou University, Taizhou, ChinaDepartment of Nephrology, The Affiliated Taizhou Second People’s Hospital of Yangzhou University, Taizhou, ChinaDepartment of Nephrology, The Affiliated Taizhou Second People’s Hospital of Yangzhou University, Taizhou, ChinaDepartment of Nephrology, The Affiliated Taizhou Second People’s Hospital of Yangzhou University, Taizhou, ChinaDepartment of Nephrology, The Affiliated Taizhou Second People’s Hospital of Yangzhou University, Taizhou, ChinaDepartment of Endocrinology, The Affiliated Taizhou Second People’s Hospital of Yangzhou University, Taizhou, ChinaObjective With the increase of patients with end-stage renal disease (ESRD), most of are receiving hemodialysis, hypoglycemia is a frequent occurrence in ESRD patients due to alterations in glucose and insulin metabolism. The purpose of our study was to explore the correlation between hypoglycemia and long-term survival in patients with ESRD during hemodialysis.Methods Using the database of Hemodialysis Center in Taizhou Second People’s Hospital, 268 ESRD patients undergoing maintenance hemodialysis (MHD) for more than 3 months between January 1, 2019 and September 30, 2023 were enrolled. Basic information, laboratory tests and treatment conditions of patients were collected. We analyzed the impact of hypoglycemia during hemodialysis on survival rate, and explored whether hypoglycemia is an independent risk factor for mortality in MHD patients.Results We found that factors such as BMI, smoking, and alcohol consumption didn’t affect survival rate in ESRD patients, while all-cause mortality was higher in ESRD patients with diabetes, cardiovascular diseases, cerebrovascular disease and experienced hypoglycemia during hemodialysis (p < 0.05). We also observed that almost all ESRD patients with diabetes experienced hypoglycemia during dialysis, and 87.5% experienced ≥3 times, while this phenomenon was hardly observed in nondiabetic ESRD patients. Cox proportional hazards model analysis found that, frequent hypoglycemia (≥3 times) was associated with higher mortality risk in ESRD patients (p = 0.041), adjusted hazard ratios (95% confidence intervals) 3.998 (2.462–6.492).Conclusions Occurrence of hypoglycemia during dialysis was associated with a higher risk of death, frequent hypoglycemia (≥3 times) was an independent risk factor for death in MHD patients.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2484471End-stage renal disease (ESRD)hypoglycemiamaintenance hemodialysis (MHD)mortalitydiabetes
spellingShingle Yuwen Shi
Tao Wang
Zhihui Ding
Lijuan Yan
Chunlei Yao
Hua Qian
Frequent hypoglycemia during hemodialysis in ESRD patients leads to higher risk of death
Renal Failure
End-stage renal disease (ESRD)
hypoglycemia
maintenance hemodialysis (MHD)
mortality
diabetes
title Frequent hypoglycemia during hemodialysis in ESRD patients leads to higher risk of death
title_full Frequent hypoglycemia during hemodialysis in ESRD patients leads to higher risk of death
title_fullStr Frequent hypoglycemia during hemodialysis in ESRD patients leads to higher risk of death
title_full_unstemmed Frequent hypoglycemia during hemodialysis in ESRD patients leads to higher risk of death
title_short Frequent hypoglycemia during hemodialysis in ESRD patients leads to higher risk of death
title_sort frequent hypoglycemia during hemodialysis in esrd patients leads to higher risk of death
topic End-stage renal disease (ESRD)
hypoglycemia
maintenance hemodialysis (MHD)
mortality
diabetes
url https://www.tandfonline.com/doi/10.1080/0886022X.2025.2484471
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