Growth during Continuous Ambulatory Peritoneal Dialysis (CAPD)

Santo, Natale G. De; Gilli, Giuseppe; Capasso, Giovambattista; Leo, Valentina; Giordano, C

doi:10.1177/039139888200500601

Cited by 8 publications

(9 citation statements)

References 10 publications

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“…Diabetic PD patients, especially in cases with poor glycaemic control, frequently need higher GBPDS concentrations that contribute to higher PGLI, more glucose absorption from the peritoneal dialysis fluid, leading to higher HbA 1c , more peritoneal membrane damage, increased membrane permeability, stimulation of the inflammatory process and fluid accumulation. [9][10][11][12] No significant correlations between the analysed parameters and the dry weight were observed in the present study.…”

Section: Discussionmentioning

confidence: 64%

“…9 Glucose absorption from PD solutions also contributes to the harmful effects on the metabolic profile and hydration status. [10][11][12] Some observational studies showed a higher risk for death in older diabetic PD patients compared with those on haemodialysis. 13 Therefore, reducing the PGL is particularly important in PD patients to reduce the risk for progression of CV complications.…”

Section: Introductionmentioning

confidence: 99%

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The impact of the peritoneal glucose load index on hydration status and inflammation in peritoneal dialysis patients

Hassan

Edgem

et al. 2014

J Int Med Res

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Objective: To evaluate the impact of the peritoneal glucose load (PGL) on hydration status and inflammation in peritoneal dialysis (PD) patients. Methods: This cross-sectional study evaluated stable PD patients using a novel PGL index (PGLI), which was calculated as the net glucose content (g) in the PD solutions administered in the daily PD prescription divided by the dry body weight (kg) assessed by whole-body bioimpedance spectroscopy. The relationship between PGLI and glycosylated haemoglobin (HbA 1c ), fluid overload (FO), and inflammatory markers was investigated. Results: A total of 43 stable PD patients participated in the study. Significant positive correlations were found between PGLI and HbA 1c , FO, plasma high sensitivity C-reactive protein (hsCRP), and plasma interleukin-6 (IL-6) levels. HbA 1c , FO, plasma hsCRP and plasma IL-6 levels were significantly higher in patients with PGLI >3 g/kg/day compared with those with PGLI 3 g/kg/day. Conclusions: PGLI values >3 g/kg/day may be associated with poor glycaemic control, over hydration and augmented inflammation. PGLI might be a useful tool for the quantitative assessment of the PGL and could be applied when managing PD patients.

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

The impact of the peritoneal glucose load index on hydration status and inflammation in peritoneal dialysis patients

Hassan

Edgem

et al. 2014

J Int Med Res

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“…However, glucose absorption from daily PD with a glucose-based dialysate can be as high as 100 -300 g daily (1)(2)(3). This absorption can worsen a patient's metabolic profile and lead to weight gain, hyperglycemia, dyslipidemia, and cardiovascular diseases (CVDs).…”

mentioning

confidence: 99%

Risk Factors for High Dialysate Glucose use in PD Patients—A Retrospective 5-Year Cohort Study

Hung²,

et al. 2010

Perit Dial Int

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♦ Results: The study group included 47 men and 43 women with a mean age of 53.4 ± 13.9 years. Technique survival rates were 91.0%, 84.1%, and 77.6% at the beginning of the second, third, and fourth year of PD therapy respectively. The presence of diabetes mellitus (DM), high body mass index (BMI), and low weekly renal Kt/V were significantly correlated with high average dialysate glucose concentration during the first, second, and third years. For patients undergoing PD for more than 3 years, residual renal function (RRF) deteriorated, and only DM significantly affected higher dialysate glucose concentration in the fourth year.♦ Conclusions: Patients with DM, high BMI, and low RRF were more likely to require a high glucose load for PD therapy, especially during the first 3 years. After those 3 years of PD, DM was the only significant factor in the need for higher glucose load. To reduce the glucose load in chronic PD patients, alternative osmotic agents such as icodextrin or amino acids should be considered in the daily PD regimen.

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“…However, the rate of glucose diffusion through the peritoneal membrane will presumably be at its greatest during the initial stages of an exchange when the dialysate concentrations are at their highest level. Thus, studies have shown that the most rapid decrease in glucose concentration occurs directly after a dialysate exchange and that the rate gradually becomes less with increasing dwell time [7,8]. Dilution of the dialysate due to ultrafiltration will, of course, contri bute to this decrease, especially in the case of the higher osmolar solution.…”

Section: Discussionmentioning

confidence: 99%

Effect of Dialysate Glucose Load on Plasma Glucose and Glucoregulatory Hormones in CAPD Patients

Armstrong¹,

Creutzfeldt²,

Ebert³

et al. 1985

Nephron

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The effect of a dialysate exchange with both 1.5 and 4.25% glucose solutions on plasma levels of glucose, insulin, gastric inhibitory polypeptide (GIP), and glucagon has been investigated in 5 continuous ambulatory peritoneal dialysis (CAPD) patients. Only in the case of the 4.25% solution did plasma glucose levels rise above 100 mg/dl. 4 of the 5 patients responded to this change with a marked insulin secretion. Employing the 1.5% solution, plasma glucose remained stable and only a slight insulin stimulation was observed in 2 patients. It is concluded that provided the 4.25% dialysates are used only occasionally, there will be no continuous stimulation of the pancreatic β-cells due to absorption of glucose from the dialysate alone during CAPD treatment. GIP levels are highly elevated in CAPD patients. A dialysate exchange with either a 1.5 or a 4.25% glucose solution had no effect on this gastrointestinal hormone. Hyperglucagonemia was also observed in this collective. An initial suppression of glucagon levels occurred in 4 of the patients after a 4.25% dialysate exchange. The 5th patient demonstrated an initial rise followed by a later decrease in glucagon, a response similar to that reported in adult onset diabetes after an oral glucose tolerance test.

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Growth during Continuous Ambulatory Peritoneal Dialysis (CAPD)

Cited by 8 publications

References 10 publications

The impact of the peritoneal glucose load index on hydration status and inflammation in peritoneal dialysis patients

The impact of the peritoneal glucose load index on hydration status and inflammation in peritoneal dialysis patients

Risk Factors for High Dialysate Glucose use in PD Patients—A Retrospective 5-Year Cohort Study

Effect of Dialysate Glucose Load on Plasma Glucose and Glucoregulatory Hormones in CAPD Patients

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