High glucose concentrations in peritoneal dialysate are associated with all-cause and cardiovascular disease mortality in continuous ambulatory peritoneal dialysis patients

Perit Dial Int. 2015 Jan-Feb;35(1):70-7. doi: 10.3747/pdi.2013.00083. Epub 2013 Dec 1.


Background: The effect of high peritoneal dialysate glucose concentration (PDGC) on all-cause and cardiovascular disease (CVD) mortality in peritoneal dialysis (PD) patients is unclear.

Objective: Our study aimed to investigate the effect of high PDGC on all-cause and CVD mortality in continuous ambulatory PD (CAPD) patients.

Methods: The study enrolled 716 patients newly initiated on CAPD therapy between January 2006 and December 2010. We allocated the patients to low (< 1.56%), medium (≥ 1.56% to < 1.74%), and high (≥ 1.74%) average PDGC groups according to the tertile of average PDGC in the first 6 months after PD initiation. Cox regression and ordinal logistic regression were used to analyze determinants of mortality and of PDGC use respectively.

Results: Mean follow-up in the study cohort was 31 ± 15 months. The all-cause mortality was 4.7 events per 100 patient-years, and the leading cause of death was CVD. Patients with a higher PDGC had significantly higher cumulative rates of all-cause (log-rank p < 0.001) and CVD mortality (log-rank p < 0.001). In Cox regression analysis, high PDGC independently predicted higher all-cause (hazard ratio: 2.63; p = 0.004) and CVD mortality (hazard ratio: 2.78; p = 0.01). Compared with a lower PDGC, a higher PDGC was significantly associated with older age [odds ratio (OR): 1.02; p < 0.001], low residual renal function (OR: 0.91; p < 0.001), and high dialysate-to-plasma ratio of creatinine (OR: 28.61; p < 0.001) in ordinal logistic regression.

Conclusions: Higher PDGC is associated with higher allcause and CVD mortality in CAPD patients.

Keywords: Cardiovascular disease; glucose concentration; mortality; outcomes; peritoneal dialysate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / mortality*
  • Cause of Death*
  • Cohort Studies
  • Dialysis Solutions / adverse effects*
  • Female
  • Glucose / adverse effects*
  • Glucose / analysis
  • Humans
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / therapy*
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Peritoneal Dialysis, Continuous Ambulatory / methods
  • Peritoneal Dialysis, Continuous Ambulatory / mortality*
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Survival Rate
  • Treatment Outcome


  • Dialysis Solutions
  • Glucose