title: Does low peritoneal glucose load protect from the development of left ventricular hypertrophy in peritoneal dialysis patients?
abstract: BACKGROUND
  Left ventricular hypertrophy (LVH) is a major predictor of the development of cardiovascular events that is considered the main cause of morbidity and mortality in peritoneal dialysis (PD) patients. This study aimed to evaluate retrospectively the impact of low peritoneal glucose load on left ventricular mass (LVM) in PD patients.
  
  
  METHODS
  36 patients who were on continuous ambulatory PD for at least a period of 2 years enrolled in the study. Of them, 23 patients received only glucose-based solutions (GBS) [high peritoneal glucose load group (HPGL group)] from the start of PD, and 13 patients received AAS in combination with GBS when their serum albumin decreased to levels <3.5 g/dl [low peritoneal glucose load group (LPGL group)]. AAS was substituted with 1.36 % GBS when serum albumin rose to ≥3.5 g/dl and restarted when serum albumin fell to <3.5 g/dl. Medical history, physical findings, echocardiographic, laboratory and hydration status data from the first month of PD and after 24 months, were obtained from each patient's medical records.
  
  
  RESULTS
  Mean LVM index (LVMI) increased in both groups (p ≤ 0.010). The increment in mean LVMI was higher in HPGL group compared to LPGL group (p = 0.006). At 24 months: peritoneal glucose load index (PGLI), fluid overload, mean arterial pressure (MAP), HbA1c and hsCRP were higher in HPGL group (p ≤ 0.010), while 24 h ultrafiltration, weekly Kt/V, serum albumin levels and RRF were higher in LPGL group (p ≤ 0.025). The increment (Δ between the values of each parameter from the start of PD and after 24 months) in PGLI, fluid overload, MAP, HbA1c and hsCRP values were higher in HPGL group (p < 0.001).
  
  
  CONCLUSIONS
  Low peritoneal glucose load may be associated with a protective effect from the development of LVH in PD patients.
authors.affiliation: Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel. drkamalh@hotmail.com.|Department of Nephrology and Hypertension, Peritoneal Dialysis Unit, Western Galilee Hospital, Nahariya, Israel. drkamalh@hotmail.com.|Galilee Medical Center, Nahariya, Israel. drkamalh@hotmail.com.
authors.forename: Kamal
authors.initials: K
authors.lastname: Hassan
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Fadi
authors.initials: F
authors.lastname: Hassan
authors.affiliation: Women's Health Wing, Western Galilee Hospital, Nahariya, Israel.
authors.forename: Dunia
authors.initials: D
authors.lastname: Hassan
authors.affiliation: Clalit Health Services, Haifa, Israel.
authors.forename: Saab
authors.initials: S
authors.lastname: Anwar
authors.affiliation: Internal Medicine Department, Carmel Medical Center, Haifa, Israel.
authors.forename: Hassan
authors.initials: H
authors.lastname: Shadi
mesh_terms: D000328:Adult; D000368:Aged; D062186:Arterial Pressure; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D015314:Dialysis Solutions / Q000008:administration & dosage / Q000009:adverse effects*; D004452:Echocardiography; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000009:adverse effects*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D007557:Israel; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D000075462:Serum Albumin, Human; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D015314:Dialysis Solutions; D005947:Glucose; D006442:Glycated Hemoglobin; D012709:Serum Albumin; D000075462:Serum Albumin, Human; C422455:ALB protein, human; C517652:hemoglobin A1c protein, human
keywords: Left ventricular hypertrophy; Left ventricular mass; Peritoneal dialysis; Peritoneal glucose load