Dialysis adequacy in diabetic and non-diabetic patients

Background and Objective: The adequacy of hemodialysis as a predictor of mortality of hemodialysis patients is widely known. In diabetic patients undergoing dialysis, blood glucose levels change and the risk of end stage renal disease (ESRD) increases. Thus, this study was conducted with the aim of determining the adequacy of hemodialysis in diabetic and nondiabetic patients who were admitted to 22-Bahman Hospital in Gonabad, Iran in 2012.

Materials and Method: In this descriptive-analytical study, 33 patients from the hemodialysis unit of 22-Bahman Hospital were recruited through the census method. They were divided into two groups of diabetic (n = 16) and nondiabetic patients (n = 17). Blood samples were taken in 3 steps before, during, and at the end of hemodialysis. Variables such as gender, age, type of filter, duration of each session, and frequency of dialysis in a week, were collected by a questionnaire. Desirable adequacy of hemodialysis was considered as KT/V > 1.2 and urea reduction ratio (URR) > 65%. Data were analyzed by SPSS₁₉ and using chi-square, Fisher’s exact test, and repeated measures ANOVA. 

Results: URR index of all the diabetic patients and 41.2% of nondiabetic patients was lower than 65%. KT/V index of 64.7% of nondiabetic and 31.3% of diabetic patients was higher than 1.2. Fisher’s exact test showed that dialysis adequacy of the two groups based on the URR index had a statistically significant difference (P = 0.007). However, the two groups had no significant difference in regard to duration of each session, frequency of dialysis in a week, type of filter, and pumping rate.

Conclusion: According to URR index, adequacy of dialysis in diabetics was lower than nondiabetic patients. Therefore, the implementation of interventions to increase the adequacy of hemodialysis in this group of patients is necessary.