Hemodialysis, serving as a crucial renal replacement therapy for patients with end-stage kidney disease, has consistently prioritized the optimization of dialysate composition in clinical practice. The application of glucose-containing dialysate has undergone a conceptual evolution from its initial role in osmotic regulation to its current recognition as a multifunctional systemic modulator. Accumulating evidence demonstrates that glucose-containing dialysate exhibits distinctive clinical advantages in maintaining glycemic and hemodynamic stability while reducing heart rate variability among hemodialysis patients. Nevertheless, existing studies present certain limitations, including relatively small sample sizes and insufficient evaluation of long-term prognostic indicators. Consequently, future investigations should emphasize large-scale, multicenter clinical trials with extended follow-up periods to further substantiate the therapeutic benefits of glucose-containing dialysate in clinical practice.