Peritoneal dialysis is a form of kidney dialysis that you can do at home. However, the sterile solution used in the process contains glucose, which can raise your blood sugar levels and lead to hyperglycemia.
When you live with diabetes, you’re at risk for certain kidney complications, including kidney failure. Treatment may require dialysis, a process that helps ease the burden on your kidneys by flushing your body of waste products.
One type of dialysis is peritoneal dialysis (PD), which you can do at home by yourself or with the help of a machine. This allows you more freedom to move around and do more tasks than you could if you did dialysis at a clinic.
However, this form of dialysis uses a sterile solution that contains glucose, and it can raise your blood sugar, leading to possible hyperglycemia during or after your dialysis.
This article will discuss the form of dialysis, your risk for hyperglycemia, and you can manage that higher blood sugar. We’ll also discuss other complications that can arise from PD treatment and hyperglycemia, in general.
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Those choosing PD as a treatment option may find the at-home use and portability of the dialysis machine to be the most appealing factors. But it can also present challenges for people with diabetes, given that the sterile solution used may contain glucose and cause your blood sugars to rise.
People with diabetes are able to use PD, but they’ll want to work with their diabetes and healthcare to monitor their blood sugars during and after the procedure.
What is peritoneal dialysis?
Peritoneal dialysis (PD) is a treatment for kidney failure. The procedure uses a membrane that lines your abdominal wall, called the peritoneum, to filter waste products from your blood.
Healthcare professionals start by implanting a plastic tube in your abdomen. The tube is called a catheter. Once the area around the catheter heals, you hook the end outside your body to a bag filled with a sterile mixture.
The fluid flows slowly into your abdomen, where it absorbs waste products. Then it drains out into the empty bag, which you throw away. You can do this up to six times per day or hook up to a machine that does it for you at night.
People with diabetes who undergo PD may have a higher risk of hyperglycemia, which means having too much sugar in your bloodstream. A blood sugar level above 140 mg/dl indicates hyperglycemia.
How quickly your blood sugar rises during PD depends on several factors, including:
- how quickly your body metabolizes sugar
- the amount of insulin you’re taking
- the proportion of sugar in the solution
- how long it remains in your body
Dialysis solutions generally contain 1,360 to 3,860 mg/dL of glucose. Those may seem like high numbers, but don’t be alarmed. Your body absorbs it because the concentration of glucose is higher in the solution than in your body.
Although there are no specific guidelines on how much insulin to give if you’re going through dialysis, they may make that determination to increase insulin during or after dialysis along with other factors that play a part in your diabetes management.
The primary way healthcare professionals treat dialysis–associated hyperglycemia is by administering insulin during treatment.
They also help you keep your blood sugar level managed all of the time, not just during dialysis.
Some symptoms of very high blood sugar include:
- extreme thirst
- frequent urination
- tiredness
- listlessness
- nausea
- dizziness
If you have diabetes and experience hyperglycemia, the American Diabetes Association recommends checking your blood and managing it if it’s too high.
For those without a diabetes diagnosis, if you suspect you have hyperglycemia, you may want to discuss your symptoms with your healthcare team to rule out the condition.
In a 2021 study of 707 people who underwent PD, the most common complication was catheter-related infection. People with diabetes were more likely to experience an infection. Their catheter implants also lasted a shorter time: 2.5 years for people with diabetes versus 7.4 years for people without diabetes.
Other possible side effects of PD treatment
- peritonitis, an abdominal infection
- hernia
- weight gain
Discuss your blood sugar level and diabetes management plan before you start PD. It’s a good idea to have a friend or family member with you during the process.
You should immediately seek medical attention if you show signs of infection. Those signs include:
- feeling sick to your stomach or throwing up
- fever
- pain in your belly
- redness, tenderness, or swelling around your catheter
- dialysis solution that’s an unusual color or cloudy
- the part of the catheter that holds it in place is pushing out
That said, it’s uncommon to have a severe medical emergency during at-home dialysis because your healthcare team will help you put safeguards in place.
Peritoneal dialysis is an at-home treatment for renal failure, which can provide more freedom to do other tasks while undergoing the process at home. PD uses your own abdominal lining to filter wastes from your blood using a sterile solution that may contain some types of sugar.
PD may lead to hyperglycemia in some people, especially those with diabetes. Discuss your blood sugar management plan with your doctor before beginning PD or another dialysis program.