Safety issues of long-term glucose load in patients on peritoneal dialysis--a 7-year cohort study

PLoS One. 2012;7(1):e30337. doi: 10.1371/journal.pone.0030337. Epub 2012 Jan 23.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cohort Studies
  • Demography
  • Female
  • Glucose / administration & dosage*
  • Glucose / adverse effects*
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Peritoneal Dialysis*
  • Proportional Hazards Models
  • Risk Factors
  • Survival Analysis
  • Time Factors

Substances

  • Glucose