Evaluation of the impact of high-volume online hemodiafiltration on glycemic status, hydration status, and body fat content in diabetic patients

Abstract

Abstract Background: The increasing patients with diabetes undergoing hemodialysis (HD) have concerned about the issue of glucose delivery with substitution fluid. We evaluate the effects of online high-volume hemodiafiltration (OL-HDF) versus high flux HD (HF-HD) on the influence of glycemic status and body fat content in patients with type 2 diabetes mellitus (T2DM) receiving HD. Objectives: The influence glucose in substitution fluid on glycemic status and body fat content in patients with type 2 diabetes mellitus. Methods: This study evaluated 117 patients receiving HD for more than 3 months (17 patients with T2DM receiving high-volume OL-HDF and the other 100 patients receiving HF-HD). Initially, we performed a cross-sectional study and later examined two modalities of high-volume OL-HDF in a 9-month cross-over study. Overall glycemic control was estimated from the fasting blood glucose (FBG) and the hemoglobin A1c (HbA1c) levels. Body composition and nutritional status were assessed by bioimpedance spectroscopy. Results: FBG and HbA1c were not significantly different in both groups of patients after having followed for 12 weeks. No significant differences were found in overhydration status and body fat content between the two therapy modalities. The blood hemoglobin (Hb) level increased in the high-volume OL-HDF group compared with the HF-HD group. Additionally, no differences were observed in glycemic status, body mass index, or body fat mass between both high-volume pre- and post-dilutional OL-HDF. Conclusion: High-volume OL-HDF did not have an adverse impact on glycemic status, body mass index, and body fat content in patients with diabetes undergoing HD in our short-term study. A large-scale and long-term follow-up study is required to confirm these results.