Law, S;
Davenport, A;
(2020)
Glucose absorption from peritoneal dialysate is associated with a gain in fat mass and a reduction in lean body mass in prevalent peritoneal dialysis patients.
British Journal of Nutrition
, 123
(11)
pp. 1269-1276.
10.1017/S0007114520000306.
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Abstract
The majority of peritoneal dialysates use glucose to generate an osmotic gradient for the convective removal of water and sodium. Although glucose can potentially be absorbed, previous studies have failed to establish whether this leads to increased fat weight gain. We measured body composition using bioimpedance in peritoneal dialysis (PD) patients, electively starting PD, attending for their first assessment of peritoneal membrane function after 2-3 months, and then after 12 months. We studied 143 patients; 89 (62.2%) males, 53 (37.1%) diabetics, mean age 61.3±14.9 years, with 90 (62.1%) of patients treated by automated PD cyclers (APD) with a daytime icodextrin exchange and 37 (25.9%) by continuous ambulatory PD (CAPD). Median fat mass increased by 1.8 (-0.5 to 4.1) kg, whereas fat free mass fell -1.3 (-2.9 to 1.0) kg, and the increase in fat mass was negatively associated with the fall in soft lean mass (r-0.41, p<0.001). Increased fat mass was associated with measured peritoneal glucose absorption (r=0.69, p<0.001), and glucose absorption was associated with the amount of 22.7 g/L glucose dialysate (odds ratio (OR) 2.0, 95% confidence limits (CL) 1.5-2.5, p<0.001), peritoneal urea clearance (OR 9.5 (CL 2.4-37.1) p=0.001), and male gender (OR 4.8 (CL 1.5-14.9) p=0.008). We report an observational study in prevalent PD patients following body composition from their first assessment of peritoneal dialysis membrane function for approximately 12 months, and despite the majority of patients prescribed icodextrin, we have demonstrated an association between intra-peritoneal glucose absorption and fat weight gain, but also loss of fat-free mass.
| Type: | Article |
|---|---|
| Title: | Glucose absorption from peritoneal dialysate is associated with a gain in fat mass and a reduction in lean body mass in prevalent peritoneal dialysis patients |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1017/S0007114520000306 |
| Publisher version: | https://doi.org/10.1017/S0007114520000306 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Kt/Vurea, fat mass, glucose, lean body mass, peritoneal dialysis |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10092835 |
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