ArticleInternational urology and nephrology2026
A study on the dose-response relationship between glycemic variability and in-dialysis hypotension in patients with diabetes undergoing hemodialysis.
Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo investigate the dose-response relationship between Glycemic variability (GV) and Intradialytic hypotension (IDH) in diabetic hemodialysis (MHD) patients, identify the critical Coefficient of variation (CV) threshold, and inform precision glucose management.
methodsThis prospective cohort enrolled 240 diabetic MHD patients (2023-2024). Continuous glucose monitoring provided GV parameters (CV, MAGE, SD). Patients were divided into IDH (n = 98) and non-IDH (n = 142) groups. Restricted cubic spline (RCS) analyzed dose-response; multivariate logistic regression assessed independent effects, with Subgroup analysis and interaction tests.
resultsCV was significantly higher in the IDH group (42.3% vs. 26.5%, P<0.001). RCS revealed a nonlinear positive correlation (P<0.001). When CV>36%, IDH risk increased sharply (threshold effect). Each 10% CV rise increased IDH risk by 98.4% (OR 1.984). Compared to Q1, Q3 (OR 3.512) and Q4 (OR 8.637) showed significantly higher risk. Associations were stronger in patients aged ≥60 years, dialysis duration ≥36 months, or with cardiovascular disease (interaction P<0.05). CV predicted IDH with AUC=0.856; optimal cutoff 36.5% (sensitivity 78.6%, specificity 82.4%).
conclusionA significant dose-response relationship exists between GV and IDH. CV>36% is an independent risk factor. Maintaining CV below 36% may reduce IDH risk and improve outcomes.
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