Does increased glucose exposure lead to increased body fat and reduced lean body mass in anuric peritoneal dialysis patients?

Residual renal function has been reported to be a major determinant of peritoneal dialysis (PD) technique survival for patients with end-stage kidney disease. Anuria leads to increases in PD prescriptions designed to maintain small solute clearances and ultrafiltration volumes, resulting in greater exposure to hypertonic glucose dialysates. We reviewed the effect of developing anuria in a cohort of 136 PD patients followed for a median of 12 months, to determine whether increasing exposure to higher glucose dialysates affected body composition by increasing body fat and reducing muscle mass. Despite increasing prescription of 22.7 and 38.6 g/l glucose dialysates there was no increase in body fat (31.1±15.4 vs 30.9±16.3 kg) or loss of fat-free weight (36.4±12.1 vs 35.8±12.3 kg). Changing PD prescriptions to maintain small solute clearances and ultrafiltration volumes did not lead to detrimental changes in body composition in the short term.