Longitudinal changes in peritoneal solute transport rate and the impact of lower glucose degradation product glucose dialysates

TL;DR

This study found that using dialysates with lower glucose degradation products helps maintain stable peritoneal solute transport rates in long-term dialysis patients.

Contribution

The study demonstrates that low GDP dialysates can prevent the increase in peritoneal solute transport rates observed with standard dialysates.

Findings

Creatinine PSTR increased with standard glucose dialysates over time.

PSTR remained stable and lower with low GDP dialysates.

Low GDP dialysate use increased from 15.6% to 44.7% over six years.

Abstract

Peritoneal solute transfer rates (PSTR) are reported to increase with time. Changes in PSTR were reviewed in long‐term peritoneal dialysis (PD) patients to determine whether lower glucose degradation products (low GDP) dialysates prevented an increase in PSTR.

PSTR was determined with a 4‐h peritoneal equilibrium test with a 2.0 L 22.7 g/L glucose dialysate.

One hundred twenty‐three PD patients treated for ≥4 years, 47.2% male, age 61 ± 16 years, 31.7% diabetic. Initially, 15.6% were treated with low GDP dialysates, which rose to 44.7% at 6 years. Creatinine PSTR increased with standard glucose dialysates (0.72 ± 0.1 at Year 3 to 0.79 ± 0.1 Year 5 and 0.82 ± 0.1 Year 6, p < 0.05), whereas PSTR was stable and lower with low GDP dialysates (0.71 ± 0.1, 0.65 ± 0.1, 0.68 ± 0.1); p < 0.001 for Years 5 and 6.

Exposure to standard glucose dialysates resulted in faster peritoneal solute transfer rates over time, whereas peritoneal solute transfer rates appeared more stable with lower glucose degradation products dialysates.

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