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Hypertonic glucose-based peritoneal dialysate is associated with higher blood pressure and adverse haemodynamics as

Nicholas M Selby1, Sally Fonseca, Lisa Hulme

  • 1Department of Renal Medicine, Derby City Hospital, Uttoxeter Road, Derby DE22 3NE, UK.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|June 24, 2005
PubMed

Insights

High glucose concentrations in continuous ambulatory peritoneal dialysis (CAPD) fluids significantly increase blood pressure by raising cardiac output. These hemodynamic changes may negatively impact patient outcomes.

Area of Science:

  • Nephrology
  • Cardiovascular Physiology

Background:

  • Continuous ambulatory peritoneal dialysis (CAPD) is widely used for end-stage renal failure.
  • Hemodynamic effects of CAPD, particularly with glucose-based solutions, are not well understood.

Purpose of the Study:

  • To investigate the hemodynamic effects of CAPD using different glucose concentrations and icodextrin.
  • To assess the impact of these fluids on blood pressure and cardiac function.

Main Methods:

  • Prospective crossover study involving eight CAPD patients.
  • Non-invasive measurement of blood pressure and hemodynamic variables (HR, SV, CO, TPR) during dwells with 1.36% glucose, 3.86% glucose, and 7.5% icodextrin.

Main Results:

  • Blood pressure was significantly higher with 3.86% glucose dwells compared to 1.36% glucose or icodextrin.
  • Increased heart rate, stroke volume, and cardiac output contributed to higher blood pressure with 3.86% glucose.
  • Total peripheral resistance remained similar across all fluid types.

Conclusions:

  • CAPD fluids with high glucose concentrations induce significant hemodynamic changes.
  • These changes, including elevated blood pressure and cardiac output, may have adverse long-term consequences for CAPD patients.
  • Beyond glycemic control and peritoneal membrane effects, CAPD fluid composition impacts systemic hemodynamics.
Abstract

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