+1 Recommend
1 collections
      Call for Papers in Kidney and Blood Pressure ResearchKidney Function and Omics Science

      Submission Deadline: December 20, 2023

      Submit now

      • Record: found
      • Abstract: found
      • Article: found

      Initial Glucose Load Predicts Technique Survival in Patients on Chronic Peritoneal Dialysis


      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.


          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.

          Related collections

          Most cited references12

          • Record: found
          • Abstract: not found
          • Article: not found

          Diagnosis and classification of diabetes mellitus.

            • Record: found
            • Abstract: found
            • Article: not found

            Meta-analysis: peritoneal membrane transport, mortality, and technique failure in peritoneal dialysis.

            Peritoneal membrane solute transport in peritoneal dialysis (PD) patients is assessed by the peritoneal equilibration test, which measures the ratio of creatinine in the dialysate to plasma after a standardized 4-h dwell (D/Pc). Patients then are classified as high, high-average, low-average, or low transporters on the basis of this result. A meta-analysis of observational studies was carried out to characterize the relationship between D/Pc and mortality and technique failure in patients who are on PD. Citations were identified in Medline by using a combination of Medical Subject Heading search terms and key words related to PD, peritoneal membrane permeability/transport, and mortality and technique failure. The table of contents of relevant journals and bibliographies of relevant citations were reviewed in duplicate. Twenty studies that met study criteria were identified. Nineteen studies were pooled to generate a summary mortality relative risk of 1.15 for every 0.1 increase in the D/Pc (95% confidence interval 1.07 to 1.23; P < 001). This result equated to an increased mortality risk of 21.9, 45.7, and 77.3% in low-average, high-average, and high transporters, respectively, as compared with patients with low transport status. Meta-regression analysis showed that the proportion of patients who were on continuous cycler PD within a study was inversely proportional to the mortality risk (P = 0.05). The pooled summary relative risk for death-censored technique failure was 1.18 (95% confidence interval 0.96 to 1.46; P = 0.12) for every 0.1 increase in the D/Pc. This meta-analysis demonstrates that a higher peritoneal membrane solute transport rate is associated with a higher mortality risk and a trend to higher technique failure.
              • Record: found
              • Abstract: found
              • Article: not found

              New-onset hyperglycemia in nondiabetic chinese patients started on peritoneal dialysis.

              Glucose has been used as the osmotic agent added to standard peritoneal dialysis (PD) solutions since its inception. Patients who have no history of glucose intolerance may develop hyperglycemia after the initiation of PD therapy. However, the prevalence and long-term implications of new-onset hyperglycemia in PD patients has not been studied. We studied 405 consecutive patients with renal failure newly started on PD therapy. Fasting plasma glucose levels 1 month after being stable on PD therapy were reviewed. Clinical factors affecting fasting plasma glucose levels were explored. Patients were followed up for 49.7 +/- 28.4 months. Of 405 patients, 136 had underlying diabetic nephropathy and another 17 had preexisting diabetes before starting PD therapy. Of the remaining 252 patients, fasting plasma glucose levels were greater than 200 mg/dL (>11.1 mmol/L) in 21 (8.3%) and 126 to 200 mg/dL (7.0 to 11.1 mmol/L) in 48 patients (19.0%). Seven patients required insulin therapy, 3 required low-dose sulfonylurea therapy, and all other patients had glucose levels controlled by means of dietary restriction only. Fasting plasma glucose levels significantly correlated with patient age (Pearson r = 0.278; P or=11.1 mmol/L) and 65.9% for patients with preexisting diabetes, respectively (overall log rank test, P 5.6 mmol/L), is associated with worse survival in PD patients.

                Author and article information

                Am J Nephrol
                American Journal of Nephrology
                S. Karger AG
                September 2008
                24 April 2008
                : 28
                : 5
                : 765-771
                aDepartment of Internal Medicine, Yun-Lin Branch, National Taiwan University Hospital, Yun-Lin, and bDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
                128608 Am J Nephrol 2008;28:765–771
                © 2008 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                : 28 December 2007
                : 17 March 2008
                Page count
                Figures: 1, Tables: 4, References: 21, Pages: 7
                Original Report: Patient-Oriented, Translational Research

                Cardiovascular Medicine,Nephrology
                Peritoneal transport,Technique survival analysis,Peritoneal dialysis,Diabetes mellitus,Patient survival analysis,Mortality


                Comment on this article