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Related Experiment Videos

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
PubMed
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.

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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:

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  • 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.