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The strong relation between post-hemodialysis blood methylglyoxal levels and post-hemodialysis blood glucose concentration rise

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Abstract

Background

Hemodialysis is known to decrease blood glucose concentration (BGC), insulin, and methylglyoxal levels. However, the effects of decreases in these factors on the increase in post-hemodialysis BGC remain unknown. This study identifies the effects of hemodialysis-induced changes in concentrations of these elements on post-hemodialysis BGC.

Methods

Study subjects included seventeen insulin-treated diabetes patients receiving hemodialysis. The fluctuations in BGC on hemodialysis-treatment days and non-hemodialysis-treatment days were evaluated using a continuous glucose monitoring system. BGC was evaluated before breakfast, before starting hemodialysis, at the end of hemodialysis, 1 h post-hemodialysis (lunch), and 6 h post-hemodialysis (dinner). BGC, insulin, and methylglyoxal levels were measured at the start and end of hemodialysis. This study also evaluated the changes in the concentrations of glucose and insulin in the arterial line and the venous line during hemodialysis.

Results

Hemodialysis decreases BGC, insulin, and methylglyoxal levels. Concentrations of glucose and insulin in the arterial line gradually decreased during dialysis, while concentrations in the venous line approached their original concentrations in the dialysis solution. BGC rose sharply after eating lunch 1 h post-hemodialysis. The blood glucose, insulin, and methylglyoxal concentrations at the end of hemodialysis were associated with the M values and the mean amplitude of glycemic excursion values between before lunch and dinner. In particular, methylglyoxal concentration at the end of hemodialysis was strongly related to the post-hemodialysis increase in BGC.

Conclusion

Hemodialysis-induced decreases in methylglyoxal concentrations and methylglyoxal concentration at the end of hemodialysis influence post-hemodialysis fluctuations in BGC.

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Acknowledgments

The authors acknowledge the editorial assistance and clinical support of Miss Manami Shimizu for her help with preparing the references and for her expert assistance with the management of blood and urinary samples. We would like to express our sincere gratitude to all staff at the facilities involved with the hemodialysis procedures that assisted us with this study. We also acknowledge the clinical support of the doctors who provided expert management of health care support, and for the case registrations. This work was supported by a 21st Century Center of Excellence Program Special Research Grant from the Ministry of Education, Sports, and Culture.

Conflict of interest

No potential conflicts of interest.

Author information

Authors and Affiliations

  1. Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan

    Miho Senda, Susumu Ogawa, Kazuhiro Nako, Masashi Okamura, Takuya Sakamoto & Sadayoshi Ito

  2. Section of Clinical Education, Division of Research in Student Support, Institute for Excellence in Higher Education, Tohoku University, Sendai, Japan

    Susumu Ogawa

Authors
  1. Miho Senda
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  2. Susumu Ogawa
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  3. Kazuhiro Nako
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  4. Masashi Okamura
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  5. Takuya Sakamoto
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  6. Sadayoshi Ito
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Corresponding author

Correspondence to Susumu Ogawa.

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Senda, M., Ogawa, S., Nako, K. et al. The strong relation between post-hemodialysis blood methylglyoxal levels and post-hemodialysis blood glucose concentration rise. Clin Exp Nephrol 19, 527–533 (2015). https://doi.org/10.1007/s10157-014-1018-6

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  • DOI: https://doi.org/10.1007/s10157-014-1018-6

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