Beta-blockers may cause ultrafiltration failure in peritoneal dialysis patients

Objective: To elucidate mechanisms of ultrafiltration failure (UFF) in patients an continuous ambulatory peritoneal dialysis (GAPD). Design: Retrospective analysis of patients with UFF during CAPD compared with cross-sectionally selected controls. Setting: University peritoneal dialysis center. Patients: Thirteen patients with UFF during CAPD necessitating change to hemodialysis (n = 6) or continuous cycling peritoneal dialysis (n = 1), or causing greatly increased need for high glucose-containing solutes, were compared with 18 CAPD patients without such problems. Statistics: Fisher's exact test, Student's independent t-test, univariate and multivariate correlation analyses. Main Outcome Measures: Data were collected prior to analyses. Results: Systolic blood pressure and total cholesterol and triglyceride levels were higher in the UFF patients than in the controls (p = 0.006, p = 0.028, p = 0.013), Beta-blockers were used by 12 of the UFF patients, but only 2/18 controls (p < 0.0001). There was no intergroup difference in number of women, patient age or weight, incidence of diabetes or previous peritonitis, duration of PD, serum levels of albumin, creatinine, iron, or ferritin, or dosage of erythropoietin. Correlation was found between the daily amount of glucose instilled into the abdomen and serum triglycerides (r = +0.12, p < 0.001), total cholesterol (r = +0.56, p = 0.008), and HbA(1) C(r = -0.41, p = 0.039). Many patients were high absorbers of dialysis glucose. Conclusion: The study indicates that beta-blockers may cause UFF, and that glucose and lipid metabolism differed between these patients and controls without UFF.