P1177THE INFLUENCE OF PERITONEAL GLUCOSE LOAD ON LEAN AND ADIPOSE TISSUE MASS IN PERITONEAL DIALYSIS PATIENTS USING A NOVEL AND QUANTITATIVE INDEX

Abstract

Abstract Background and Aims There is now widespread consensus among nephrologists to increase the number of patients on peritoneal dialysis (PD). Most of the PD dialysis solutions are based on glucose as an osmotic agent. The peritoneal glucose load can damage the peritoneal membrane, increases its permeability to water, glucose and electrolytes leading to the development of fluid overload, hypertension, stimulation of the inflammatory process and metabolic disturbances. This study aims to verify the influence of glucose exposure load on lean and adipose tissue mass in PD patients using a novel and quantitative index. Method This is a retrospective and analytical study based on the medical records. The study examined the entire population of PD patients who were treated at the Peritoneal Dialysis Unit at the Galilee Medical Center in north of Israel during the last eight years (from January 1, 2010 through December 31, 2017). The clinical and laboratory data of these patients were collected from their medical records and analyzed. The main variables examined included peritoneal glucose load index (PGLI), lean tissue index (LTI) and Fat Tissue Index (FTI). LTI was calculated as the quotient of LTM/Height?(kg/m? and FTI was defined as the quotient of ATM/Height?(kg/m?. LTI and FTI were assessed using the Fresenius Medical Care Body Composition Monitor (BCM) device, based on Bio-impedance technology Results 187 assessments of the nutritional status in PD patients, using the BCM device, were evaluated. Among PD patients, 52.4% were men, 54% were treated with continuous ambulatory peritoneal dialysis (CAPD) and 46% had diabetes mellitus as primary renal disease. The average age was 57.8 ± 11.3 years, peritoneal dialysis vintage 31.36 ± 16.69 months, body mass index (BMI) 28.1 ± 4.4 kg/m2, daily urinary output 1040.0 ± 649.8 ml/day, hemoglobin 10.84 ± 1.02 g/dl, HbA1c 7.05 ± 1.09 %, Kt/V 1.89 ± 0.17, PGLI 3.11 ± 1.13 g/kg/day, residual renal function 6.68 ± 2.46 ml/min/1.73m2. A significant and positive correlation between the PGLI and FTI (r=0.28, p<0.001) and, a significant and negative association between PGLI and LTI (r=-0.24, p<0.001) were found. Conclusion Peritoneal glucose load may adversely influence the nutritional status of PD patients by increasing the adipose tissue mass and decreasing lean tissue mass.