Impact of Body Composition and Anemia on accuracy of a real-time Continuous Glucose Monitor in Diabetes patients on Continuous Ambulatory Peritoneal Dialysis.

Continuous glucose monitoring (CGM) has been proposed as an alternative for glycemic assessment in patients on dialysis. Volume overload and anemia are common in patients on peritoneal dialysis, but their impact on sensor accuracy remains unknown. This is an exploratory analysis of a prospective study of Guardian Connect™ with Guardian Sensor™ 3 in 30 participants with diabetes on continuous ambulatory peritoneal dialysis (CAPD) (Age [mean ± SD] 64.7±5.6 years, 23 men, body mass index (BMI) 25.4±3.9 kg/m2, blood hemgolobin (Hb) 10.7±1.3 g/dL). Sensor accuracy was evaluated during an 8-hour in-clinic session with glucose challenge. The mean absolute relative difference (MARD) was calculated between paired sensor and YSI 2300 STAT venous glucose readings (n=941). Body composition was evaluated using multi-frequency bioimpedance spectroscopy. The overall MARD across the full glycemic range was 10.4% (95% 9.6-11.7%). There were no correlations between BMI, total body water, extracellular water, relative hydration index, lean mass, fat mass with MARD. No significant correlations were observed between MARD and hemoglobin (r=0.016, p>0.05) In summary, this real-time CGM demonstrated good accuracy in CAPD with minimal influence from body composition and anemia. Further studies are required to confirm generalizability of our findings to other sensors and dialysis populations.