Kamal Hassan1,2,3, Fadi Hassan4, Dunia Hassan5, Saab Anwar6, Hassan Shadi7. 1. Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel. drkamalh@hotmail.com. 2. Department of Nephrology and Hypertension, Peritoneal Dialysis Unit, Western Galilee Hospital, Nahariya, Israel. drkamalh@hotmail.com. 3. Galilee Medical Center, Nahariya, Israel. drkamalh@hotmail.com. 4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 5. Women's Health Wing, Western Galilee Hospital, Nahariya, Israel. 6. Clalit Health Services, Haifa, Israel. 7. Internal Medicine Department, Carmel Medical Center, Haifa, Israel.
Abstract
BACKGROUND: Left ventricular hypertrophy (LVH) is a major predictor of the development of cardiovascular events that is considered the main cause of morbidity and mortality in peritoneal dialysis (PD) patients. This study aimed to evaluate retrospectively the impact of low peritoneal glucose load on left ventricular mass (LVM) in PD patients. METHODS: 36 patients who were on continuous ambulatory PD for at least a period of 2 years enrolled in the study. Of them, 23 patients received only glucose-based solutions (GBS) [high peritoneal glucose load group (HPGL group)] from the start of PD, and 13 patients received AAS in combination with GBS when their serum albumin decreased to levels <3.5 g/dl [low peritoneal glucose load group (LPGL group)]. AAS was substituted with 1.36 % GBS when serum albumin rose to ≥3.5 g/dl and restarted when serum albumin fell to <3.5 g/dl. Medical history, physical findings, echocardiographic, laboratory and hydration status data from the first month of PD and after 24 months, were obtained from each patient's medical records. RESULTS: Mean LVM index (LVMI) increased in both groups (p ≤ 0.010). The increment in mean LVMI was higher in HPGL group compared to LPGL group (p = 0.006). At 24 months: peritoneal glucose load index (PGLI), fluid overload, mean arterial pressure (MAP), HbA1c and hsCRP were higher in HPGL group (p ≤ 0.010), while 24 h ultrafiltration, weekly Kt/V, serum albumin levels and RRF were higher in LPGL group (p ≤ 0.025). The increment (Δ between the values of each parameter from the start of PD and after 24 months) in PGLI, fluid overload, MAP, HbA1c and hsCRP values were higher in HPGL group (p < 0.001). CONCLUSIONS: Low peritoneal glucose load may be associated with a protective effect from the development of LVH in PD patients.
BACKGROUND:Left ventricular hypertrophy (LVH) is a major predictor of the development of cardiovascular events that is considered the main cause of morbidity and mortality in peritoneal dialysis (PD) patients. This study aimed to evaluate retrospectively the impact of low peritoneal glucose load on left ventricular mass (LVM) in PDpatients. METHODS: 36 patients who were on continuous ambulatory PD for at least a period of 2 years enrolled in the study. Of them, 23 patients received only glucose-based solutions (GBS) [high peritoneal glucose load group (HPGL group)] from the start of PD, and 13 patients received AAS in combination with GBS when their serum albumin decreased to levels <3.5 g/dl [low peritoneal glucose load group (LPGL group)]. AAS was substituted with 1.36 % GBS when serum albumin rose to ≥3.5 g/dl and restarted when serum albumin fell to <3.5 g/dl. Medical history, physical findings, echocardiographic, laboratory and hydration status data from the first month of PD and after 24 months, were obtained from each patient's medical records. RESULTS: Mean LVM index (LVMI) increased in both groups (p ≤ 0.010). The increment in mean LVMI was higher in HPGL group compared to LPGL group (p = 0.006). At 24 months: peritoneal glucose load index (PGLI), fluid overload, mean arterial pressure (MAP), HbA1c and hsCRP were higher in HPGL group (p ≤ 0.010), while 24 h ultrafiltration, weekly Kt/V, serum albumin levels and RRF were higher in LPGL group (p ≤ 0.025). The increment (Δ between the values of each parameter from the start of PD and after 24 months) in PGLI, fluid overload, MAP, HbA1c and hsCRP values were higher in HPGL group (p < 0.001). CONCLUSIONS: Low peritoneal glucose load may be associated with a protective effect from the development of LVH in PDpatients.
Entities:
Keywords:
Left ventricular hypertrophy; Left ventricular mass; Peritoneal dialysis; Peritoneal glucose load
Authors: Constantijn J A M Konings; Jeroen P Kooman; Marc Schonck; Ruben Dammers; Emiel Cheriex; Andrea P Palmans Meulemans; Arnold P G Hoeks; Bernardus van Kreel; Ulrich Gladziwa; Frank M van der Sande; Karel M L Leunissen Journal: Perit Dial Int Date: 2002 Jul-Aug Impact factor: 1.756
Authors: J D Kopple; D Bernard; J Messana; R Swartz; J Bergström; B Lindholm; V Lim; G Brunori; M Leiserowitz; D M Bier Journal: Kidney Int Date: 1995-04 Impact factor: 10.612