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

dc.contributor.advisorHerselman, M. G.
dc.contributor.advisorLabadarios, D.
dc.contributor.advisorMc'Ligeyo, S. O.
dc.contributor.advisorKayima, J. K.
dc.contributor.authorKariuki, Anastacia Wanjikuen_ZA
dc.contributor.otherUniversity of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Human Nutrition.
dc.descriptionThesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2008.
dc.description.abstractBACKGROUND: 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.en_ZA
dc.publisherStellenbosch : University of Stellenbosch
dc.subjectChronic renal patientsen_ZA
dc.subjectPrevalence of hypoglycaemiaen_ZA
dc.subjectHypoglycemia -- Nutritional aspectsen
dc.subjectChronic renal failure -- Nutritional aspectsen
dc.subjectDissertations -- Nutritionen
dc.subjectTheses -- Nutritionen
dc.titleThe prevalence and nutritional causes of hypoglycaemia in patients with end-stage renal failure (ESRF) on maintenance haemodialysis (MHD) at Kenyatta National Hospital Nairobi, Kenyaen_ZA
dc.rights.holderUniversity of Stellenbosch

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