The prevalence and nutritional causes of hypoglycaemia in patients with end-stage renal failure (ESRF) on maintenance haemodialysis (MHD) at Kenyatta National Hospital Nairobi, Kenya
Date
2008-03
Authors
Kariuki, Anastacia Wanjiku
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : University of Stellenbosch
Abstract
BACKGROUND: Although hypoglycaemia is a known complication of haemodialysis, there is
little information about its prevalence among patients on maintenance haemodialysis.
OBJECTIVE: To determine the prevalence of hypoglycaemia in patients on maintenance
haemodialysis in Kenyatta National Hospital (Nairobi, Kenya) and to identify potential nutritionrelated
causes of hypoglycaemia.
METHODS: A cross-sectional, descriptive and observational study design was followed.
Patients who had been on chronic maintenance haemodialysis for 3 months or longer were
included in the study which was carried out from May 8 through to June 30, 2006. Random
blood glucose levels were determined at baseline, 15 minutes, 30 minutes and 45 minutes, and at
hourly intervals thereafter until the end of the dialysis session. The prevalence of hypoglycaemia
(a blood glucose level less than 3.9 mmol/L) was then determined for the duration of
haemodialysis. The relationship between minimum blood glucose levels and dietary intake,
anthropometric status, primary diagnosis, co-morbid and socio-demographic factors, prescribed
medication and dialysis related factors was determined.
RESULTS: Among the 51 haemodialysis patients who participated in the study, the prevalence
of hypoglycaemia was 16% (n=8). Eight percent (n=4) of these patients were however already
hypoglycaemic on initiation of dialysis. Dietary intake of niacin ((r=0.31; p=0.02), riboflavin
(r=0.30; p=0.03) and vitamin B6 (r=0.30; p=0.03) showed a significant relationship with blood
glucose levels. The relationships between hypoglycaemic episodes and insulin administration
(p=0.06), and between blood glucose levels and BMI (r=0.25; p=0.08 and protein intake (r=0.26;
p=0.07) approached significance. There was no significant relationship between blood glucose
levels and the duration of haemodialysis (p=0.942), hours of haemodialysis (p=0.27) and the
dialysate solution used (p=0.12).
CONCLUSIONS: Hypoglycaemia was present in 16% of patients on maintenance
haemodialysis. Potential nutritional parameters which may have contributed to lower blood
glucose levels in this study include a lower dietary intake of niacin, riboflavin, and vitamin B6.
Lower protein intake and lower BMI was marginally associated with low blood glucose levels.
Description
Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2008.
Keywords
Hypoglycaemia, Haemodialysis, Chronic renal patients, Prevalence of hypoglycaemia, Hypoglycemia -- Nutritional aspects, Chronic renal failure -- Nutritional aspects, Dissertations -- Nutrition, Theses -- Nutrition