Table 3.
Summary of studies using continuous glucose monitoring technology in hemodialysis patients with advanced chronic kidney disease
| No. | Study author and year | Population | CGM duration | Results |
|---|---|---|---|---|
| 1 | Képénékian, 2014 (130) | DM2, HD, n = 28 | 2.25 d | Retrospective glycemic patterns reduced HbA1c, but no hypoglycemia |
| 2 | Gai, 2014 (131) | DM, HD, n = 12 | 6 d | Retrospective CGM use Lower glucose during HD, with nadir at third hour of HD Glycemic peak after HD occurring at 2.5 h after |
| 3 | Joubert, 2015 (108) | DM1, DM2, n = 15 | 5 d | Lower CGM glucose during HD period Retrospective use of CGM improved HbA1c and mean CGM |
| 4 | Vos, 2012 (99) | DM2, CKD no HD, n = 25 | 2 d | Good correlation of mean CGM and glycated albumin, poor with HbA1c |
| 5 | Mirani, 2010 (132) | DM2, HD, n = 12 | 3 d | High glycemic variability after HD |
| 6 | Jung, 2010 (133) | DM2, HD, n = 9 | 6 d | Hypoglycemia during and after HD |
| 7 | Sobngwi, 2010 (44) | No DM, HD, n = 14 | 4 d | Lower CGM glucose during HD, lowest glucose after 3 h |
| 8 | Riveline, 2009 (134) | DM2, HD, n = 19 | 4 d | Poor correlation of mean CGM and HbA1c |
| 9 | Chantrel, 2009 (135) | DM1, DM2, HD, n = 33 | 3 d | Frequent hypoglycemia during HD, with higher CGM glucose during early morning day after |
| 10 | Kazempour, 2009 (107) | DM2, HD, n = 17 | 2 d | Frequent hypoglycemic events, mostly after HD |
| 11 | Jhaverani, 2018 (136), | DM2, HD, n = 10 | 2 d (12 h on HD and 12 h no HD) | Mean glucose lower on HD day, particularly during 4 h of HD period |
| 12 | Sobngwi, 2010 (37) | DM, HD, n = 10 | 2 d (24 h before HD, 4 h on HD and 24 h post-HD) | Reduction of 25% in basal insulin requirements day after dialysis, compared to day before. No changes in bolus insulin requirements. Overall decrease of 15% of total daily insulin dose postdialysis |
| 13 | Presswala, 2019 (123) | DM2, CKD, no HD, n = 80 | 14 d (FreeStyle Libre Pro) | Robust correlation between CGM-derived average glucose and HbA1c and fructosamine Fructosamine not accurate for eGFR) < 30 mL/min; HbA1c not affected |
| 14 | Yajima, 2019 (124) | DM2, HD, n = 13 | 14 d (FreeStyle Libre Pro) | Overall MARD 19.5% MARD 31.9% for glucose < 70 mg/dL Only 49% and 51% of glucoses fell into zones A and B of EGA |
Abbreviations: CGM, continuous glucose monitoring; DM2, type 2 diabetes; EGA, error grid analyses; eGFR, estimated glomerular filtration rate; HbA1c, hemoglobin A1c; HD, hemodialysis; MARD, mean amplitude relative difference.