Hemodialysate solutions often contain high concentrations of glucose (up to 200 mg/dl). The historical reasons for the addition of glucose to the dialysate including following:
- enhancing ultrafiltration
- minimization of nutritional (caloric) loses during dialysis
Recent evidence suggest that exposure to high levels of glucose may be proinflammatory and their use should be re-examined. Dialysate glucose concentrations of 100 mg/dl are likely to be safe. Higher values may be predispose to the metabolic syndrome. Glucose free dialysate may be beneficial metabolically and posibly less inflammatory. However, glucose-free dialysate may be associated with hypoglicemia, particularly in poorly nourished patients, insulin-requiring diabetics or in acute hemodialysis settings
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