Glucose absorption and weight change in 18 months of continuous ambulatory peritoneal dialysis

Previous studies have suggested that weight gain is a potential problem for patients using continuous ambulatory peritoneal dialysis (CAPD) due to the influx of glucose from the dialysate. To document the relationship between weight change and glucose absorption, the authors reviewed the medical charts of eight patients from the University of Michigan Hospitals Home Training Dialysis Unit who have used CAPD for at least 18 months. The average daily glucose absorption for each patient was determined by using the equation of Grodstein et al. (y = 11.3(x) -10.9, r = .96, p less than or equal to .001). The mean weight change after 18 months of CAPD was +4.0 +/- 8.9 kg (range = -2.5 to +24.1 kg). Two patients became obese (greater than 120% IBW); one remained obese; four patients maintained desirable weight for height; and one patient became nutritionally depleted (less than 80% IBW). Differences between weights before and after 18 months of CAPD were not significant (p greater than or equal to .05); however, mean weight change was significantly correlated (r = .62, p less than or equal to .05) with average daily amounts of glucose absorbed from the dialysate. This study indicates that nutritional outcomes can be optimized if total energy intake and the passive uptake of significant amounts of glucose across the peritoneal membrane are monitored along with body weight in patients using long-term CAPD.