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Acute central haemodynamic effects induced by intraperitoneal glucose instillation
Anneleen Pletinck1, Francis Verbeke, Luc Van Bortel
1Renal Division, Department of Internal Medicine, University Hospital Ghent, Ghent, Belgium.
Summary
Peritoneal dialysis (PD) with glucose instillation did not alter central hemodynamics, even with significant increases in blood glucose and insulin levels. This study investigated the cardiovascular impact of PD fluid glucose concentrations.
Area of Science:
- Nephrology
- Cardiovascular Physiology
Background:
- Peritoneal dialysis (PD) may impact hemodynamics, with recent findings suggesting increased peripheral blood pressure during acute dwells.
- The role of intraperitoneal (IP) glucose in these hemodynamic changes is unclear, prompting investigation into its specific effects.
Purpose of the Study:
- To determine the impact of IP glucose instillation on central hemodynamic parameters during acute peritoneal dialysis.
- To differentiate the effects of glucose concentration from volume/pressure changes in PD.
Main Methods:
- A randomized, cross-over study involving 22 stable, non-diabetic PD patients.
- Patients underwent 100-minute dwells with 1.36% and 3.86% glucose peritoneal dialysis solutions.
- Central blood pressure was measured using SphygmoCor, with serial blood sampling for glucose and insulin levels.
Main Results:
- Serum glucose levels increased during both glucose concentrations, with a more pronounced rise in patients with insulin resistance.
- Insulin levels increased only during the 3.86% glucose dwell, particularly in insulin-resistant patients.
- No significant changes in central hemodynamic parameters (carotid BP, heart rate, augmentation index) were observed.
Conclusions:
- Acute peritoneal dialysis dwells with varying glucose concentrations do not induce significant changes in central hemodynamic parameters.
- The observed increases in blood glucose and insulin levels during PD do not appear to affect central hemodynamics in the short term.
