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Excessive weight gain during peritoneal dialysis
S Jolly1, C Chatatalsingh, J Bargman
1Division of Nephrology, University Health Network and University of Toronto, Ontario, Canada.
The International Journal of Artificial Organs
|June 8, 2001
Summary
Peritoneal dialysis patients gaining significant weight may absorb excess calories from dialysate, especially with high membrane transport. Genetic factors like UCP-2 gene variations might also contribute to altered metabolic rates.
Area of Science:
- Nephrology
- Metabolic Medicine
Background:
- Peritoneal dialysis (PD) is a crucial renal replacement therapy.
- Unexplained weight gain in PD patients can complicate management and affect outcomes.
Purpose of the Study:
- To investigate the characteristics and potential causes of excessive weight gain in PD patients.
- To identify patient factors associated with significant weight increase during PD therapy.
Main Methods:
- Retrospective chart review of 114 PD patients at Toronto Western Hospital Peritoneal Dialysis Unit.
- Analysis of patient demographics, clinical status, dialysis adequacy (KT/V urea), residual renal function, peritoneal membrane transport characteristics, and body composition (Bioelectrical Impedance Analysis - BIA).
Main Results:
- Eight patients (6.9%) gained ≥10 kg over two years, averaging 13.1 kg.
- These patients were predominantly male, aged 51 years, well-nourished, normotensive, non-diabetic, with normal cardiac function.
- They exhibited adequate dialysis, minimal residual renal function, and high average peritoneal membrane transport.
- BIA indicated increased fat mass and a trend towards decreased body-cell mass.
- Potential contributing factors include increased caloric intake from dialysate glucose absorption and possible UCP-2 gene polymorphism affecting metabolic rate.
Conclusions:
- Excessive weight gain in PD patients is associated with high peritoneal membrane transport and increased dialysate glucose absorption.
- This weight gain is primarily due to increased fat mass.
- Genetic factors, such as UCP-2 gene polymorphism, may play a role in altered metabolism and subsequent weight gain.