Initial glucose load predicts technique survival in patients on chronic peritoneal dialysis.
BACKGROUND
A high glucose content in peritoneal dialysis (PD) solution may result in unfavorable changes on peritoneal character and worsened metabolic profiles. We conducted this retrospective cohort analysis to investigate the impact of initial glucose load on long-term outcomes of PD patients.


METHODS
A total of 90 patients newly started on PD were enrolled. All subjects were divided into low, medium, or high glucose load equally in patient number according to the average dialysate glucose concentration prescribed in the first 6 months from PD initiation. Cox's regression was used for survival analyses and linear regression was used for analyses of determinants for glucose load.


RESULTS
The mean follow-up period was 40.1 +/- 11.8 months. Patients with higher glucose load showed a significantly worse cumulative technique survival (log rank p = 0.002). In Cox's regression analysis, patients with lower glucose load had significantly better technique survival (p = 0.035). In linear regression analysis, preexisting diabetes mellitus (p < 0.001), lower serum albumin (p = 0.012), and lower weekly renal Kt/V (p = 0.019) were significantly correlated with higher glucose load.


CONCLUSIONS
Higher glucose load during the initial period of PD was associated with higher prevalent diabetes mellitus, lower serum albumin, and lower residual renal function, and effectively predicted worse survival of PD therapy.
Wu
Hon-Yen
HY
Department of Internal Medicine, Yun-Lin Branch, National Taiwan University Hospital, Yun-Lin, Taiwan.
Hung
Kuan-Yu
KY
Huang
Jenq-Wen
JW
Chen
Yung-Ming
YM
Tsai
Tun-Jun
TJ
Wu
Kwan-Dun
KD
D015331:Cohort Studies; D048909:Diabetes Complications; D005260:Female; D005947:Glucose / Q000009:adverse effects*; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000401:mortality; D012044:Regression Analysis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D016896:Treatment Outcome
D012709:Serum Albumin; D005947:Glucose