Low blood sugar, also known as hypoglycemia, could turn out to be a serious health threat for patients with chronic kidney disease (CKD), according to a study.
The findings of the study indicate that hypoglycemia may be responsible for some portion of the excess heart-related deaths seen in CKD patients.
Glucose control is the key to preventing end-stage renal disease (ESRD) in CKD patients with diabetes.
But managing diabetes in CKD patients could be complicated because patients' reduced kidney function can influence how they react to anti-diabetes medications.
The problems in diabetes management could predispose CKD patients to episodes of hypoglycemia-a condition characterised by dizziness, disorientation, slurred speech, convulsions, and death.
Led by Dr. Jeffrey C. Fink of the University of Maryland Medical System, the study examined the incidence of hypoglycemia among CKD patients to determine whether the condition might contribute to the patients' deaths.
The researchers assessed the incidence of hypoglycemia in CKD patients relative to non-CKD patients, both with and without diabetes. They also examined the association of hypoglycemia with subsequent near term deaths (one day after blood glucose measurement).
For the analysis, the researchers collected information from 243,222 individuals who were being cared at the Veterans Health Administration, and found that the incidence of hypoglycemia was higher in patients with CKD, both among patients with diabetes and among those without.
The risk of hypoglycemia was highest in individuals with both CKD and diabetes.
Hypoglycemia increased patients' risk of dying in the near term, and the researchers claimed that there was a reduced risk of near term death in individuals with CKD relative to those without.
And they said that the attenuation in the risk of death might relate to an increased quality of care in these patients with CKD relative to diabetic patients without CKD.
"The association of hypoglycemia with one-day mortality underscores the significance of this metabolic disturbance in patients with diabetes and chronic kidney disease," said Fink.
The study will appear in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN).