If a guy is having kidney failure would that cause high blood glucose?

Daytonite, BSN, RN · Oct 23, 2006

Was this patient a diabetic? Blood sugar will still rise in diabetic patients even when they haven't eaten. Renal failure is also one of the common complications that can occur in diabetics. I think you need to review the pathophysiology of diabetes mellitus, the normal physiology of digestion and blood sugar, and how this all can relate to kidney failure.

VickyRN, MSN, DNP, RN · Oct 23, 2006

I agree with Daytonite. Don't confuse association with causation. There are two common causes of end-stage-renal disease: hypertenion and diabetes mellitus. The diabetes would come first; renal failure second. If the person is already diabetic, then blood glucose would be high, regardless of condition of kidneys.

Kidneys do have an endocrine function by the way: production of erythropoietin, renin/ angiotensin, and activation of vitamin D.

http://www.merck.com/mmhe/sec13/ch161/ch161c.html

Mesomorph · Oct 23, 2006

That's the thing... he's not diabetic.

EDIT: He was hypertensive though.

**canoehead, BSN, RN** · Oct 23, 2006

Someone who is prediabetic can get high sugars when put on some drugs- prednisone for instance.

He may be regulating his diabetes with diet when he is well and not require meds. Look at old admissions to see if his sugars went up then as well- the stress of illness may mess with his control.

Tweety, BSN, RN · Oct 23, 2006

The inflammatory response could be causing it to rise. The body is under stress because of the renal failure. This is sometimes called "stress hyperglyecemia".

They could have an undiagnosed metabolic syndrome on top of the renal failure and the 135 may be pretty normal to them. About 24% of us have insulin resistance problems. Are they overweight?

I know as a student you have to find an explanation for abnormals, but I usually don't blink an eye at 135, that's low for a hospitlized patient. :)

Like VickyRN mentioned above, the high glucose may not be caused by the renal failure, but is in addition to to the renal failure.

VickyRN, MSN, DNP, RN · Oct 23, 2006

Great responses from everyone. I am learning so much from this thread. Some other considerations that come to mind:

Certain diuretics may cause elevations in blood glucose: hydrochlorothiazide (or other thiazide-type diuretics) or furosemide (or other loop diuretics). It is very possible he would be one or both of these medications for renal failure or for high blood pressure. One of the links below states, "...diabetes mellitus may become manifest during thiazide administration."

Certain antihypertensives may also cause elevations in blood glucose: beta-blockers (metoprolol), for instance - Is he on any of these medications (or ones listed below) for hypertension?

http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203639.html

http://www.diabetesincontrol.com/issues/issue246/drugs.pdf

http://us.gsk.com/products/assets/us_dyazide.pdf

http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202087.html

http://www.drugs.com/PDR/Vaseretic_Tablets.html

Tweety, BSN, RN · Oct 23, 2006

That's interesting VickyRN, thanks for the info. I learned something too. :)

marilynmom, LPN, NP · Oct 25, 2006

135 isn't high to being with, but if that is outside the range for him stress will cause your blood sugar to be higher than normal. I once took my 6 year old to the ER and her bs was like 180 from the stress of being there (shes not diabetic or even close, her A1c was like 4%).

Stress can really do a number on your body which I think is more likely in his case, 135 isn't high to begin with.

And of course there are sooo many drugs that will increase your bs.