Background: Glucose-based peritoneal dialysis (PD) is the original PD form. However, glucose uptake from the peritoneal cavity may contribute to dysmetabolism. Methods: We retrospectively assessed metabolic syndrome (MS) and its components in 195 non-diabetic incident PD patients at baseline and after 34.3 (20.5–60.0) months of PD. MS was defined according to the Adult Treatment Panel III criteria. Results: While 22.1% of the patients met MS criteria at baseline, 69.2% (p < 0.01) exhibited MS during PD. MS burden increased significantly after PD (p < 0.01). The disorder BMI and lipids, and MS components number, correlated with peritoneal glucose exposure and PD duration (p < 0.05). In Cox analysis, age, BMI, triglyceride, C-reactive protein (CRP) and glucose exposure were all independently associated with MS development. Conclusions: PD commencement in end-stage renal disease patients was associated with an increased MS prevalence. High glucose exposure and long PD duration were associated with MS existence, along with old age, high BMI, triglyceride and CRP.

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