The impact of glucose load on left ventricular mass in peritoneal dialysis patients

Abstract

Higher PGLI values were associated with worse glycemic control and increased LVMI. Efforts should be made to minimize the PGL. All other risk factors that may contribute to the development of LVH in PD patients should be identified and treated. Additional multicenter, randomized control trials are needed to determine the target objectives of PGLI.

Associations of Peritoneal Glucose Load With Male Sexual Dysfunction and Depression in Peritoneal Dialysis Patients

“…The present study showed direct associations of PGLI with the hydration index E/I ratio and higher levels of plasma hsCRP in patients with higher PGLI. This suggests a negative impact of PGLI >3 g/kg per day on hydration status and inflammation ; and supports an association of PGLI with overhydration and augmented inflammation. In addition, since overhydration is usually accompanied by elevated blood pressure and plasma brain natriuretic peptide, vascular complications may develop .…”

“…Higher estradiol levels were found in PD patients with PGLI >3 g/kg per day, compared to those with PGLI ≤3 g/kg per day; and a significant and direct correlation was found between PGLI and estradiol levels. In addition, by contributing to the development of overhydration and aggravating the inflammatory status in PD patients , higher PGLI (>3 g/kg per day) can adversely affect sexual function through interfering with sex hormones . Since PGLI >3 g/kg per day produces cumulative peritoneal membrane damage, as discussed above, leading to the development of overhydration and elevated blood pressure and plasma BNP levels, high PGLI values (>3 g/kg per day) may adversely affect sexual function through the accompanied vascular complications .…”

“…After undergoing complete medical history and physical examination, all participants were assessed for peritoneal glucose load index (PGLI), hydration status, sexual function, psychological status and sex hormonal profile. The PGLI refers to the net glucose content (monohydrated or unhydrated) (g) in the solutions administered in the daily PD prescription, divided by the dry body weight (kg), as assessed by whole‐body bioimpedance spectroscopy : …”

“…For analysis, patients were categorized to two groups according to PGLI ≤3 g/kg per day and PGLI >3 g/kg per day. The cut‐off of 3 g/kg per day is based in our previous studies that evaluated the impact of PGLI on hydration status, inflammation and left ventricular mass in stable patients on maintenance PD . These studies demonstrated that hemoglobin A1c (HbA1c), fluid overload, plasma high sensitivity C‐reactive protein (hsCRP) and interleukin (IL)‐6 levels were significantly higher in patients with PGLI >3 g/kg per day compared with those with PGLI ≤3 g/kg per day ; PGLI was positively correlated with HbA1c and left ventricular mass index ( P < 0.001) and patients with PGLI >3 g/kg per day had higher HbA1c and left ventricular mass index compared to those with PGLI ≤3 g/kg per day ( P < 0.001) ; PGLI seemed to be possible predictor of left ventricular hypertrophy and its cutoff that was associated with the presence of LVH was 3.2 g/kg per day ; and finally, low peritoneal glucose load was associated with a protective effect from the development of left ventricular hypertrophy in PD patients .…”

Sodium and water handling during hemodialysis: new pathophysiologic insights and management approaches for improving outcomes in end-stage kidney disease

“…45 Indeed, a near linear relation between FO and left ventricular hypertrophy has been described. 78 Moreover, a relationship between FO and endothelial dysfunction, as measured by VCAM-1 and interleukin-6 levels, has recently been observed. 79 However, the fact that even small levels of FO, which are unlikely to have major hemodynamic effects, are associated with outcomes suggests that the relationship between FO and outcomes may not be directly causative.…”