Hypoglycemia in 56 hemodialysis patients: Incidence and outcome

End-stage renal disease (ESRD) is the second most common condition associated with hypoglycemia in hospitalized patients. In this study, the incidence and significance of hypoglycemia in 18 non-diabetic and 38 diabetic ESRD patients on hemodialysis (HD) was evaluated. Over a 10-year period, 56 HD patients were admitted with hypoglycemia out of a total of 1,545 HD patient admissions (3.6%). Of those patients presenting with hypoglycemia, 32% eventually died. Drug-induced hypoglycemia was the most common etiology (46%), but did not result in death. Sepsis was responsible for 39% of the episodes, and was associated with mortality in 66% of the patients. Severe malnutrition caused 7% of the hypoglycemic episodes and 16.5% of the deaths. It is concluded that hypoglycemia is not rare in ESRD patients, and is an ominous sign if in the HD patient, it is associated with either sepsis or malnutrition.