Intracorporeal Glucose Disposal During Hemodialysis After a Standardized Glucose Load

The aim of this study was to quantify intracorporeal clearance and disposal of glucose after the administration of a standardized glucose load during regular hemodialysis done in stable and non-diabetic patients and to account for effects of extracorporeal clearance. A standardized load of glucose was administered approximately 30 min after starting hemodialysis with a constant dialysate glucose of 5.0 +/- 0.2 mmol/L. Glucose in the arterial line blood and in dialysate outflow was measured at baseline and in short intervals for a period of 1 h after the infusion. Tests were repeated within 1 week. Nine patients completed the study. Extracorporeal blood and dialysate flows were 304 +/- 34 and 500 mL/min, respectively. The intracorporeal clearance of glucose was 327 +/- 137 mL/min and 69.1 +/- 9.4% of total glucose clearance. Mass balance assessed from dialysate samples showed that 60.1 +/- 10.5% of glucose injected was disposed intracorporeally. The fraction of intracorporeal clearance and the fraction of intracorporeal glucose disposal were highly correlated (r = 0.94, p < 0.0001). The fraction of glucose disposed in hemodialysis patients can be determined from the amount of glucose injected and from the amount of glucose removed extracorporeally during hemodialysis without blood sampling. This measure could be of interest in surveillance of glucose control in hemodialysis patients.