Safety issues of long-term glucose load in patients on peritoneal dialysis--a 7-year cohort study.
BACKGROUND
Effects of long-term glucose load on peritoneal dialysis (PD) patient safety and outcomes have seldom been reported. This study demonstrates the influence of long-term glucose load on patient and technique survival.


METHODS
We surveyed 173 incident PD patients. Long-term glucose load was evaluated by calculating the average dialysate glucose concentration since initiation of PD. Risk factors were assessed by fitting Cox's models with repeatedly measured time-dependent covariates.


RESULTS
We noted that older age, higher glucose concentration, and lower residual renal function (RRF) were significantly associated with a worse patient survival. We found that female gender, absence of diabetes, lower glucose concentration, use of icodextrin, higher serum high density lipoprotein cholesterol, and higher RRF were significantly associated with a better technique survival.


CONCLUSIONS
Long-term glucose load predicted mortality and technique failure in chronic PD patients. These findings emphasize the importance of minimizing glucose load in PD patients.
Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Hon-Yen
HY
Wu
Kuan-Yu
KY
Hung
Tao-Min
TM
Huang
Fu-Chang
FC
Hu
Yu-Sen
YS
Peng
Jenq-Wen
JW
Huang
Shuei-Liong
SL
Lin
Yung-Ming
YM
Chen
Tzong-Shinn
TS
Chu
Tun-Jun
TJ
Tsai
Kwan-Dun
KD
Wu
D015331:Cohort Studies; D003710:Demography; D005260:Female; D005947:Glucose / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors
D005947:Glucose