Sugar or salt: The use of 5% dextrose in the adult, non-diabetic haemodialysis population

Background: There is a lack of evidence in assisting renal clinicians in determining the optimal strategy for preventing the need for rapid ultrafiltration during haemodialysis (HD). Aim: This study aimed to compare the effectiveness of 5% dextrose for priming, reinfusion and treatment of intravascular volume depletion symptoms against 0.9% saline in non-diabetic people receiving HD. Objectives: The primary objective was to reduce interdialytic weight gain, thereby preventing rapid ultrafiltration during HD. The secondary objective was to minimise symptoms of intravascular volume depletion (hypotension, dizziness and cramping) during HD treatments. Method: The study used 0.9% saline for priming, reinfusion and treatment of intravascular volume depletion symptoms during HD for the first three months. The study then converted to using 5% dextrose for the following six months. Subjects: A total of 38 adults who had been receiving HD for a minimum of six months with a permanent vascular access were recruited with 30 participants completing the study. Results: Analysis of the data showed no difference in the interdialytic weight gain from baseline to week 11. However, from week 12 to week 20 interdialytic weight gain was found to be significantly reduced. Cramping during dialysis decreased from baseline and week 12 compared to subsequent weeks; however, this was not statistically significant (p=0.07). The pre-dialysis blood pressure was found to be elevated in participants following conversion. Conclusion: This study showed that the use of 5% dextrose can reduce interdialytic weight gain and the incidence of cramping during HD which can assist clinicians in optimising fluid removal on HD.