• Umut Varol, Yelda Varol, Mustafa Yaprak, Atilla Uzum, and Mustafa Cirit.
• Department of Internal Medicine, Izmir Centre, Izmir Ataturk Research and Training Hospital, Izmir, Turkey, varolumut@yahoo.com.
• Int Urol Nephrol. 2014 Aug 1; 46 (8): 1639-44.

PurposeLactic acidosis as a consequence of high serum lactate levels may deepen the metabolic acidosis in patients with end-stage renal failure. Besides, certain antidiabetic may also cause raised lactate levels in diabetic patients. Therefore, it is obvious that the risk of hyperlactatemia is increased by folds in diabetic patients on chronic hemodialysis program. In this study, it is aimed to evaluate the frequency and the impact of increased serum lactate levels in prevalent diabetic hemodialysis patients.MethodsA total of 100 diabetic patients who were under maintenance hemodialysis in five different dialysis centers were included in this study. All biochemical parameters, blood gas measurements, echocardiographic data and antidiabetic treatments were statistically analyzed in terms of serum lactate levels.ResultsOut of 100 patients, 12 patients had serum lactate levels over normal limits. When the patients with normal or high serum lactate levels were defined as two different groups, statistical significance was detected between serum lactate levels and serum sodium (p = 0.019), potassium (p = 0.037) and bicarbonate levels (p = 0.028). Moreover, in patients with hyperlactatemia, the ejection fraction value was found significantly low (p = 0.005).ConclusionsThe frequency of hyperlactatemia was not rare in prevalent diabetic hemodialysis patients. We additionally found that serum lactate level measurement may particularly help to diagnose the occult cardiac failure. However, further large scale studies are required to define the clinical significance of hyperlactatemia in the end-stage renal failure patients with diabetes mellitus.

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