The impact of the peritoneal glucose load index on hydration status and inflammation in peritoneal dialysis patients.
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 (HbA1c), 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 HbA1c, FO, plasma high sensitivity C-reactive protein (hsCRP), and plasma interleukin-6 (IL-6) levels. HbA1c, 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.
Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel Department of Nephrology and Hypertension, Peritoneal Dialysis Unit, Western Galilee Hospital, Nahariya, Israel Kamal.Hassan@naharia.health.gov.il.
Kamal
K
Hassan
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Fadi
F
Hassan
Department of Nephrology and Hypertension, Peritoneal Dialysis Unit, Western Galilee Hospital, Nahariya, Israel.
Rabia
R
Edgem
Department of Nephrology and Hypertension, Peritoneal Dialysis Unit, Western Galilee Hospital, Nahariya, Israel.
Smadar
S
Moshe
Department of Internal Medicine, Carmel Medical Centre, Haifa, Israel.
Shadi
S
Hassan
D002097:C-Reactive Protein / Q000378:metabolism; D003710:Demography; D003920:Diabetes Mellitus / Q000097:blood; D015314:Dialysis Solutions / Q000494:pharmacology*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000473:pathology*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D012372:ROC Curve; D015203:Reproducibility of Results
D002097:C-Reactive Protein; D015314:Dialysis Solutions; D005947:Glucose; D006442:Glycated Hemoglobin; D015850:Interleukin-6
Peritoneal dialysis; fluid overload; glucose load; glucose load index; inflammation