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PD Glucose Absorption Metabolic Effects — ESENeph MCQ

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ModeratePeritoneal DialysisPD Glucose Absorption Metabolic EffectsESENeph

A 60-year-old woman on PD develops progressive weight gain, hypertriglyceridaemia, and poor glycaemic control over 3 years of PD. Her HbA1c has risen from 52 to 65 mmol/mol. What PD-specific factor contributes to metabolic derangement?

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Correct answer: B — Continuous glucose absorption from glucose-based PD dialysate (150-250 g glucose/day absorbed) contributes to weight gain, hyperglycaemia, hypertriglyceridaemia, and metabolic syndrome

Glucose-based PD dialysate exposes the peritoneum to large quantities of glucose. Approximately 60-80% of the dialysate glucose is absorbed systemically, equivalent to 150-250 g glucose/day (600-1000 extra kcal/day). This contributes to weight gain, worsening diabetes control, hypertriglyceridaemia, and insulin resistance. Mitigation strategies include: using Icodextrin for the long dwell (glucose-free), minimising high-concentration glucose bags, dietary calorie adjustment, and optimising diabetes medication.

Reference: ISPD 2020 – PD Metabolic Complications; UKKA 2017 – PD