Key result
Hypoglycemia linked to ~213% higher arrhythmia rate in non-diabetic hemodialysis patients.
Why the study?
The study aimed to examine arrhythmias and hypoglycaemia in individuals receiving haemodialysis and investigate the association of arrhythmias with hypoglycaemia, hyperglycaemia, and glycaemic variability.
Does hypoglycaemia increase the rate of arrhythmias in individuals with and without diabetes receiving maintenance haemodialysis?
Cohort (n=70)
Yes
Does hypoglycaemia increase the rate of arrhythmias in individuals with and without diabetes receiving maintenance haemodialysis?
Absolute Event Rate: 34% vs 31%
Hypoglycaemia is common in haemodialysis patients regardless of diabetes status and is temporally associated with a significantly increased rate of arrhythmias in those without diabetes.
Hypoglycaemia was associated with more arrhythmias in non-diabetic haemodialysis patients; hypothesis-generating for glucose management trials.
AIMS/HYPOTHESIS: We aimed to examine arrhythmias and hypoglycaemia among individuals with and without diabetes who are receiving haemodialysis and to investigate the association between arrhythmias and hypoglycaemia, hyperglycaemia and glycaemic variability. METHODS: This prospective multicentre cohort study included 70 participants on maintenance haemodialysis (35 with diabetes and 35 without diabetes). We employed implantable cardiac monitors for continuous heart rhythm monitoring in combination with periodic use of continuous glucose monitoring. Logistic-regression-type linear mixed models were used to examine associations between arrhythmias and glycaemic measures. RESULTS: During 18 months of follow-up, clinically significant arrhythmias (bradyarrhythmia and ventricular tachycardia) were identified in 12 (34%) participants with diabetes and 11 (31%) without diabetes. Atrial fibrillation was detected in 13 (37%) participants with diabetes and 14 (40%) without, while other supraventricular tachycardia was detected in seven (20%) and 11 (31%) participants with and without diabetes, respectively. Hypoglycaemia (sensor glucose <3.9 mmol/l) was observed in 27 (77%) participants with diabetes and 32 (91%) without diabetes. Compared with euglycaemia, hypoglycaemia was associated with an increased rate of arrhythmias among participants without diabetes (incidence rate ratio [IRR] 3.13 [95% CI 1.49, 6.55]), while hyperglycaemia (sensor glucose >10.0 mmol/l) was associated with a decreased rate of arrhythmias among participants with diabetes (IRR 0.58 [95% CI 0.37, 0.92]). Glycaemic variability showed no association with arrhythmias regardless of the presence of diabetes. CONCLUSIONS/INTERPRETATION: Arrhythmias and hypoglycaemia were common in those undergoing haemodialysis regardless of diabetes status. Our data suggest a temporal relationship between arrhythmias and glucose level in both individuals with and without diabetes. TRIAL REGISTRATION: Clinicaltrials.gov: NCT04841304.
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Kofod et al. (2025) conducted a cohort in End-stage kidney disease receiving maintenance haemodialysis (n=70). Diabetes vs. No diabetes was evaluated on Incidence of clinically significant arrhythmias (composite of significant bradycardia, ventricular tachycardia, or ventricular fibrillation). Clinically significant arrhythmias were common among individuals receiving haemodialysis, occurring in 34% of those with diabetes and 31% of those without diabetes, while hypoglycaemia was associated with an increased rate of arrhythmias in participants without diabetes (IRR 3.13).
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