In peritoneal dialysis, which dialysate component can cause hyperglycemia?

• A. Lactose
• B. Sorbitol
• C. Dextrose
• D. Fructose

Answer: (C)

Hyperglycemia exposure in peritoneal dialysis comes from the glucose (dextrose) used as the osmotic agent in the dialysate. Dextrose is drawn from the dialysate across the peritoneal membrane into the bloodstream during the dwell. The amount absorbed depends on the glucose concentration of the solution and the duration of the dwell; higher concentrations and longer dwells lead to more glucose entering the circulation, which can raise blood sugar, especially in people with diabetes. Other sugars listed aren’t used as the osmotic agent in standard PD solutions, so they don’t contribute to this glucose load in the same way.