A Study on Dialysate Glucose Concentration in Patients With Continuous Ambulatory Peritoneal Dialysis

Abstract

Background: Glucose-based peritoneal dialysis (PD) is the predominantly used dialysate in PD patients. Glucose absorption in peritoneal dialysis (PD) patients may contribute to adverse metabolic complications. The impact of high peritoneal dialysate glucose concentration (PDGC) on all-cause as well as cardiovascular disease (CVD) mortality in peritoneal dialysis (PD) patients is unclear. The current researchs widely applied formulae may be not suitable for estimation of glucose absorption in continuous ambulatory peritoneal dialysis (CAPD) patients. Objective: This study examined the actual glucose absorption in a cohort of CAPD patients and compared the results with estimates from three current formulae. Our study provides an overview of glucose associated metabolic complications and to investigate the impact of high glucose in dialysate on our CAPD patients. Methods: We conducted a survey of glucose absorption of a cohort of 56 CAPD patients and compared actual dialysate glucose absorbed with the one of K/DOQI formula, Grodstein formula, or a percentage estimate of 60%. Results: The total dialysate glucose infused each day varied from 108.8 to 181.6 g/day with average of 130±19.6 g, with the mean glucose concentration in dialysate is 1.79%. The average of glucose absorbed was 83.2±24.3 g/day (ranging from 28.6 to 145.2 g) by actual measurements. The mean absorption rate was 64.1% (ranging from 22.6% to 99.6%). There are no significant differences between 4 methods estimating glucose absorption in CAPD patients. There are strong correlations between glucose concentration using in PD patients with levels of total cholesterol, triglyceride, urea, creatinine and uric acid. Only triglyceride concentration associated with glucose absorption from dialysate. Conclusions: The applications of current estimating methods may have limitations. The actual measurement providesdietitians and doctors more exact information of absorbed glucose and energy compared to the current estimating methods. Key words: dialysate, Glucose absorption, peritoneal dialysis, continuous ambulatory peritoneal dialysis, acid uric, triglyceride