Beta-Blockers May Cause Ultrafiltration Failure in Peritoneal Dialysis Patients

Objective To elucidate mechanisms of ultrafiltration failure (UFF) in patients on continuous ambulatory peritoneal dialysis (CAPD). 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). Betablockers 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 = +0.72, p < 0.001), total choles terol (r = +0.56, p = 0.008), and HbA1C(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.