Hypoglycemia after dialysis

  1. I have low blood sugar after dialysis, even though I am not diabetic. Have you seen this in the patients you take care of?

    I used to get saline at the end of every treatment, which had little effect on my blood pressure and resulted in my leaving 'heavy'-- and having a tough treatment the next time. One day I brought a juice pouch to drink at the end of my treatment and discovered that it raised my blood pressure-- I'd needed sugar and not salt at the end of my treatments. The charge nurse told me that she'd seen a few other patients with this same problem... I'm wondering how common this is. I was on hemodialysis for about six years before this started-- does this mean that long-term dialysis modifies one's metabolism?
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  2. 10 Comments

  3. by   jnette
    Interesting, Dar... haven't seen that yet at our clinic, but I'll inquire about it tomorrow.

    The dialysate bath should be equalizing your electrolytes... usually if our pts. come in with an elevated blood sugar, it will come down withing the first hour.. and vice versa.. if they are low, it will raise it. These are diabetics, however, so it may be different.

    I'll ask my NM tomorrow and see what she has to say.
  4. by   Dialyzin' Dar
    Thanks, Jnette.

    Today I went out and bought some Zebra pens-- my nephrologist will get a kick out of that, because I am a 'medical zebra'-- somebody who always ends up with the oddball disease or condition.
  5. by   Hellllllo Nurse
    I don't know the answer to your question about hypoglycemia and dialysis, Dar, but I love your tag-line, lol!
  6. by   jnette
    Hey Dar !

    OK... talked to my NM today... she said the only reason she could imagine this happening to you (and I hate to be the bearer of bad news ) is that most likely you are prediabetic. The dialysate is set at a certain dextrose amounts (as is the bicarb, ca+. etc.)... and if your blood varies anywhere along those values, then, of course it diffuses over.

    Apparently the drop of bld. sugar is an indication of diabetic concerns down the road, and she advised you to be sure to follow up on this, and speak to your nephrologist about it.

    Hope you can get some clarification from your doc, and I wish you the best, ok? (((HUGS))) :kiss
  7. by   Dialyzin' Dar
    I already asked about that, and neither my nephrologist nor the dietician feel I am at a risk for developing diabetes. I feel I dodged a bullet by not developing diabetes from 3 years of taking prednisone when I had the kidney transplant-- that's one thing nobody mentioned when I was in transplant evaluation! I found that out on my own, through reading the Nephrology journals that were carelessly left in the waiting room!

    I'm betting that the low blood sugar is partially caused by the propranolol I'm taking for tachycardia... but the low sugar started before I started on the medication. Anyway, thanks for responding, Jnette!
  8. by   jnette
    Quote from Dialyzin' Dar
    I already asked about that, and neither my nephrologist nor the dietician feel I am at a risk for developing diabetes. I feel I dodged a bullet by not developing diabetes from 3 years of taking prednisone when I had the kidney transplant-- that's one thing nobody mentioned when I was in transplant evaluation! I found that out on my own, through reading the Nephrology journals that were carelessly left in the waiting room!

    I'm betting that the low blood sugar is partially caused by the propranolol I'm taking for tachycardia... but the low sugar started before I started on the medication. Anyway, thanks for responding, Jnette!

    Wish I had a better answer for ya, Dar... that's all we could come up with.. if your nephrologist doesn't know, then I sure as HECK can't answer it !!!

    By the way.. (and you probably already know of these sites, I would think.. as you are quite knowlegable and active in your own care..) Here are a couple great links for you ... just in case:

    http://www.ikidney.com/iKidney/home.htm

    http://www.hdcn.com/
  9. by   Dialyzin' Dar
    Thank you, Jnette! I'm familiar with ikidney, but have never been to hdcn. I have bookmarked it-- lots of stuff to read there.

    I wish I could get the other patients interested in their care-- I know that in my case, learning about my disease and treatment has given me a sense of being in control of what happens to me. So many of the patients feel like they're playing Russian roulette each time they come to dialysis-- they think it's only 'luck' when they have a good treatment. I think that's why many of them don't appreciate how hard the nurses and techs work-- they only hold the nurses responsible when something goes wrong, not when things go well.
  10. by   jnette
    Quote from Dialyzin' Dar
    Thank you, Jnette! I'm familiar with ikidney, but have never been to hdcn. I have bookmarked it-- lots of stuff to read there.

    I wish I could get the other patients interested in their care-- I know that in my case, learning about my disease and treatment has given me a sense of being in control of what happens to me. So many of the patients feel like they're playing Russian roulette each time they come to dialysis-- they think it's only 'luck' when they have a good treatment. I think that's why many of them don't appreciate how hard the nurses and techs work-- they only hold the nurses responsible when something goes wrong, not when things go well.
    And I too, wish more patients took a greater interst in their care, for it really is a two way street... there's only so much we can do. I just love the handful of patients we have that ARE interested, ask questions, and are willing to learn all they can. And I love to teach, so we then compliment each other and it makes it a nice experience for both of us.

    If you ever get down my way for business or pleasure, be sure to call our clinic and set up a transient appointment !!!
  11. by   Northern nephron
    I too am looking for any information on blood sugar levels and dialysis. I was always under the impression that the "bath" with its set glucose level would equalize the serum sugar level to the bath or close to it. Any infor/links on this would be appreciated.
  12. by   Farkinott
    Quote from Dialyzin' Dar
    I have low blood sugar after dialysis, even though I am not diabetic. Have you seen this in the patients you take care of?

    I used to get saline at the end of every treatment, which had little effect on my blood pressure and resulted in my leaving 'heavy'-- and having a tough treatment the next time. One day I brought a juice pouch to drink at the end of my treatment and discovered that it raised my blood pressure-- I'd needed sugar and not salt at the end of my treatments. The charge nurse told me that she'd seen a few other patients with this same problem... I'm wondering how common this is. I was on hemodialysis for about six years before this started-- does this mean that long-term dialysis modifies one's metabolism?
    Are you dialisying in a high glucose bath eg K2 D10? If you are in a D5 maybe you need o change.

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