| 1. |
- Bazargani, Farhan, 1969, et al.
(författare)
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Low molecular weight heparin improves peritoneal ultrafiltration and blocks complement and coagulation.
- 2005
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Ingår i: Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis. - : Multimed Inc.. - 0896-8608 .- 1718-4304. ; 25:4, s. 394-404
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Clinical studies have demonstrated that the intraperitoneal (IP) complement and coagulation systems are activated in peritoneal dialysis (PD) patients. In animal models, low molecular weight heparin (LMWH) was seen to inhibit peritoneal angiogenesis, and related compounds have increased ultrafiltration volumes after repeated administration to PD patients. The present study evaluated the effects of LMWH on ultrafiltration, coagulation, and complement activation during a single PD dwell. DESIGN: Rats were exposed to a single dose of 20 mL 2.5% glucose-based, filter-sterilized PD fluid, with or without supplementation with LMWH. The PD fluid was administered either as an IP injection or as an infusion through an indwelling catheter. The dwell fluid was analyzed 2 hours later concerning activation of the complement and coagulation cascades, chemotactic activity, neutrophil recruitment, ultrafiltration volume, and glucose and urea concentrations. RESULTS: Exposure to PD fluid induced activation of IP complement [formation of C3a (desArg) and increase of C5a-dependent chemotactic activity] and coagulation (formation of thrombin-antithrombin complex) and recruitment of neutrophils. In the case of IP injection, neutrophil recruitment and complement activation were inhibited by LMWH. In both models, LMWH inhibited thrombin formation, reduced complement-dependent chemotactic activity, and increased the IP fluid volume, indicating an improved ultrafiltration. CONCLUSIONS: The acute inflammatory reaction to PD fluid involves the complement and coagulation cascades. Addition of LMWH to the PD fluid improves ultrafiltration, inhibits formation of thrombin, and potentially blocks C5a activity. The present results motivate further investigations of the IP cascade systems in PD.
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| 2. |
- Bazargani, Farhan, 1969-, et al.
(författare)
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The roles of complement factor C5a and CINC-1 in glucose transport, ultrafiltration, and neutrophil recruitment during peritoneal dialysis
- 2006
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Ingår i: Peritoneal Dialysis International. - : Sage Publications. - 0896-8608 .- 1718-4304. ; 26:6, s. 688-696
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Tidskriftsartikel (refereegranskat)abstract
- Background: In a recent experimental study, we showed that low molecular weight heparin improved ultrafiltration and blocked complement activation and coagulation in a single peritoneal dialysis (PD) dwell.Objective: The aim of the present study was to evaluate the possible contribution of the complement factor C5a and the potential interactions between C5a, the coagulation system, and cytokines of the interleukin (IL)-8 family (cytokine-induced neutrophil chemoattractant; CINC-1).Methods: Nonuremic rats were exposed through an in-dwelling catheter to a single dose of 20 mL glucose- (2.5%) based fifter-sterilized PD fluid, with or without the addition of anti-rat CS antibody. The dwell fluid was analyzed 2 and 4 hours later concerning activation of the coagulation cascades, neutrophil recruitment, ultrafiltration volume; CINC-1, glucose, urea, and histamine concentrations; and ex vivo intraperitoneal chemotactic activity. Results: The numbers of neutrophils and levels of thrombin-antithrombin complex (TAT) and CINC-1 increased significantly during the PD dwell. C5 blockade significantly reduced the levels of TAT and increased the ultrafiltration volumes at 2 hours. Glucose concentrations were significantly positively correlated to ultrafiltration volumes.Conclusions: Blockade of C5 Leads to an increase in ultrafiltration, probably by a mechanism that involves a reduction in glucose transport. This effect may form a basis for improving PD efficiency in situations where high glucose transport limits ultrafiltration. Mechanisms connected to complement activation during PD may involve coagulation. Further studies of the intraperitoneal cascade systems under conditions of PD are indicated.
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| 3. |
- Erixon, Martin, et al.
(författare)
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3,4-dge in peritoneal dialysis fluids cannot be found in plasma after infusion into the peritoneal cavity.
- 2008
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Ingår i: Peritoneal Dialysis International. - 1718-4304. ; 28:3, s. 277-282
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Glucose degradation products (GDPs) are important in the outcome of peritoneal dialysis (PD) treatment. 3,4-dideoxyglucosone-3-ene (3,4-DGE) is the most cytotoxic GDP found in conventionally manufactured fluids and may, in addition, be recruited from 3-deoxyglucosone (3-DG). It is not known what happens with those GDPs in patients during PD. The aim of this study was to investigate if the 3,4-DGE and 3-DG in PD fluids can be found in plasma during treatment. DESIGN: PD patients were dialyzed with a conventional PD fluid containing 43 mumol/L 3,4-DGE and 281 mumol/L 3-DG. Parallel experiments were performed in rats as well as in vitro with human plasma. The rats were dialyzed with a PD fluid containing 100 mumol/L 3,4-DGE and 200 mumol/L 3-DG. RESULTS: The concentration of 3,4-DGE in the peritoneum decreased at a much higher rate than 3-DG during the dwell. 3,4-DGE was not, however, detected in the plasma of patients or rats during dialysis. The concentration of 3-DG in plasma peaked shortly after infusion of the fluid to the peritoneal cavity. The concentration of 3,4-DGE during experimental incubation in plasma decreased rapidly, while the concentration of 3-DG decreased only 10% as rapidly or less. CONCLUSION: 3,4-DGE could not be detected in plasma from either PD patients or rats during dialysis. This is presumably due to its high reactivity. 3-DG may, on the other hand, pass through the membrane and be detected in the blood.
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| 4. |
- Erixon, Martin, et al.
(författare)
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3,4-dideoxyglucosone-3-ene in peritoneal dialysis fluids infused into the peritoneal cavity cannot be found in plasma.
- 2009
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Ingår i: Peritoneal Dialysis International. - 1718-4304. ; 29 Suppl 2, s. 28-31
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Glucose degradation products (GDPs) are important for the outcome of peritoneal dialysis (PD) treatment. The most cytotoxic GDP found in conventionally manufactured fluids, 3,4-dideoxyglucosone-3-ene (3,4-DGE), may in addition be recruited from 3-deoxyglucosone (3-DG). What happens with the GDPs in the fluid infused into patients during PD is not known. We investigated whether 3,4-DGE and 3-DG in PD fluid can be found in plasma during treatment. DESIGN: Patients on PD were dialyzed with a conventional PD fluid containing 43 micromol/L 3,4-DGE and 281 micromol/L 3-DG. Parallel experiments were performed in rats and in vitro with human plasma. The rats were dialyzed with a PD fluid containing 100 micromol/L 3,4-DGE and 200 micromol/L 3-DG. RESULTS: The 3,4-DGE concentration in the peritoneum declined at a much higher rate during the dwell than did the 3-DG concentration. However, 3,4-DGE was not detected in the plasma of patients or of rats during dialysis. The 3-DG concentration in plasma peaked shortly after infusion of fluid into the peritoneal cavity. The 3,4-DGE concentration during experimental incubation in plasma declined rapidly; the 3-DG concentration declined only 10% as rapidly (or less). CONCLUSION: During dialysis, 3,4-DGE could not be detected in plasma of either PD patients or rats, presumably because of its high reactivity. On the other hand, 3-DG may pass through the membrane and be detected in the blood.
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| 5. |
- Erixon, Martin, et al.
(författare)
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How to avoid glucose degradation products in peritoneal dialysis fluids
- 2006
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Ingår i: Peritoneal Dialysis International. - 1718-4304. ; 26:4, s. 490-497
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The formation of glucose degradation products (GDPs) during sterilization of peritoneal dialysis fluids (PDFs) is one of the most important aspects of biocompatibility of glucose-containing PDFs. Producers of PDFs are thus trying to minimize the level of GDPs in their products. 3,4-Dideoxyglucosone-3-ene (3,4-DGE) has been identified as the most bioreactive GDP in PDFs. It exists in a temperature-dependent equilibrium with a pool of 3-deoxyglucosone (3-DG) and is a precursor in the irreversible formation of 5-hydroxymethyl furaldehyde (5-HMF). The aim of the present study was to investigate how to minimize GDPs in PDFs and how different manufacturers have succeeded in doing so. Design: Glucose solutions at different pHs and concentrations were heat sterilized and 3-DG, 3,4-DGE, 5-HMF, formaldehyde, and acetaldehyde were analyzed. Conventional as well as biocompatible fluids from different manufacturers were analyzed in parallel for GDP concentrations. Results: The concentrations of 3-DG and 3,4-DGE produced during heat sterilization decreased when pH was reduced to about 2. Concentration of 5-HMF decreased when pH was reduced to 2.6. After further decrease to a pH of 2.0, concentration of 5-HMF increased slightly, and below a pH of 2.0 it increased considerably, together with formaldehyde; 3-DG continued to drop and 3,4-DGE remained constant. Inhibition of cell growth was paralleled by 3,4-DGE concentration at pH 2.0-6.0. A high glucose concentration lowered concentrations of 3,4-DGE and 3-DG at pH 5.5 and of 5-HMF at pH 1. At pH 2.2 and 3.2, glucose concentration had a minor effect on the formation of GDPs. All conventional PDFs contained high levels of 3,4-DGE and 3-DG. Concentrations were considerably lower in the biocompatible fluids. However, the concentration of 5-HMF was slightly higher in all the biocompatible fluids. Conclusion: The best way to avoid reactive GDPs is to have a pH between 2.0 and 2.6 during sterilization. If pHs outside this range are used, it becomes more important to have There are large variations in GDPs, both within and between biocompatible and conventionally manufactured PDFs.
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| 6. |
- Erixon, Martin, et al.
(författare)
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Take care in how you store your PD fluids: Actual temperature determines the balance between reactive and non-reactive GDPs
- 2005
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Ingår i: Peritoneal Dialysis International. - 1718-4304. ; 25:6, s. 583-590
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Tidskriftsartikel (refereegranskat)abstract
- Objective: During heat sterilization and during prolonged storage, glucose in peritoneal dialysis fluids (PDF) degrades to carbonyl compounds commonly known as glucose degradation products (GDPs). Of these, 3,4-dideoxyglucosone-3-ene (3,4-DGE) is the most cytotoxic. It is an intermediate in degradation between 3-deoxyglucosone (3-DG) and 5-hydroxymethyl-2-furaldehyde (5-HMF). We have earlier reported that there seems to be equilibrium between these GDPs in PDF. The aim of the present study was to investigate details of this equilibrium. Methods: Aqueous solutions of pure 3-DG, 3,4-DGE, and 5-HMF were incubated at 40 degrees C for 40 days., Conventional and low-GDP fluids were incubated at various temperatures for up to, 3 weeks. Formaldehyde, acetaldehyde, glyoxal, methylglyoxal, 3-DG, 3,4-DGE, and 5-HMF were analyzed using high performance liquid chromatography. Results: Incubation of 100 mu mol/L 3,4-DGE resulted in the production of 36 mu mol/L 3-DG, 4 mu mol/L 5-HMF, and 40 mu mol/L unidentified substances. With the same incubation, 200 mu mol/L 3-DG was converted to 9 mu mol/L 3,4-DGE, 6 mu mol/L 5-HMF, and 14 mu mol/L unidentified substances. By contrast, 100 mu mol/L 5-HMF was uninfluenced by incubation. In a conventional PDF incubated at 60 degrees C for 1 day, the 3,4-DGE concentration increased from 14 to a maximum of 49 mu mol/L. When the fluids were returned to room temperature, the concentration decreased but did not reach original values until after 40 days. In a low GDP fluid, 3,4-DGE increased and decreased in the same manner as in the conventional fluid but reached a maximum of only 0.8 mu moL/L. Conclusions: Considerable amounts of 3,4-DGE maybe recruited by increases in temperature in conventional PDFs. Lowering the temperature will again reduce the concentration but much more time will be needed. Precursors for 3,4-DGE recruitment are most probably 3-DG and the enol 3-deoxyaldose-2-ene, but not 5-HMF. Considering the ease at which 3,4-DGE is recruited from its pool of precursors and the difficulty of getting rid of it again, one should be extremely careful with the temperatures conventional PDFs are exposed to.
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| 7. |
- Johansson, Ann-Cathrine, et al.
(författare)
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Physiological properties of the peritoneum in an adult peritoneal dialysis population over a three-year period
- 2006
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Ingår i: Peritoneal Dialysis International. - 1718-4304. ; 26:4, s. 482-9
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe the physiological properties of the peritoneal membrane in adult patients treated with peritoneal dialysis (PD) and to analyze the effects of patient characteristics and time. Design: Observational study. Setting: Department of Nephrology at the Sahlgrenska University Hospital. Method: Peritoneal function was analyzed by the Personal Dialysis Capacity (PDC) test, based on the three-pore theory of capillary transport. The functional PDC variables are absorption, large-pore flow, and the area parameter (A(0)/Delta x), which determines the diffusion of small solutes. The ultrafiltration (UF) coefficient is determined mainly by A(0)/Delta x. Patients: All patients (n = 280) who had at least one PDC test done between September 1990 and August 1999. Results: In 249 patients examined soon after start of PD, area was 19000 (SD 7100) cm(2)/cm/1.73 m(2), large-pore flow 0.112 (SD 0.052) mL/min/1.73 m(2), and the UF coefficient 0.071 (SD 0.032) mL/minute/mmHg/1.73 m(2). Absorption was 1.54 (SD +2.64, -0.97) mL/min/1.73 m(2). Large-pore flow was greater in patients with severe comorbidity than in patients with fewer comorbid conditions. Elderly patients had a lower UF coefficient than did younger patients (p < 0.05). Repeated PDC tests were performed in 208 patients during a mean observation time of 18.4 months. There was a slight increase in the slope of the area-versus-time curve of 54 cm(2)/cm/1.73 m(2) per month (approximately 10% after 3 years, p < 0.01); all other parameters remained constant. Conclusion: Patient characteristics have an impact on peritoneal performance already at the start of dialysis. Peritoneal function can remain essentially stable during medium long-term PD.
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| 8. |
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| 9. |
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| 10. |
- Rippe, Bengt
(författare)
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How to assess transport in animals?
- 2009
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Ingår i: Peritoneal Dialysis International. - 1718-4304. ; 29:Suppl. 2, s. 32-35
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Tidskriftsartikel (refereegranskat)abstract
- The general principles for assessing solute and fluid transport across the peritoneum in animal models are not different from those in human studies. Animal models allow for extensive standardization of experimental conditions and also for sampling of peritoneal tissues for analysis. The present review will focus on (1) the scaling issue between various species, (2) how to measure intraperitoneal volume in animal models, (3) the impact of an indwelling catheter, (4) the difference between acute and chronic experiments, and (5) the particular problems associated with transport measurements in mice. If done correctly and after proper scaling, mass transfer area coefficients and clearance measurements show marked similarity among different species. Although animal models only partly mimic human peritoneal dialysis, they are valuable tools for understanding the basic physiology and biology of peritoneal dialysis.
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| 11. |
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| 12. |
- Rippe, Bengt, et al.
(författare)
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Optimum electrolyte composition of a dialysis solution.
- 2008
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Ingår i: Peritoneal Dialysis International. - 1718-4304. ; 28 Suppl 3, s. 131-136
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Forskningsöversikt (refereegranskat)abstract
- In patients undergoing peritoneal dialysis (PD) for end-stage renal failure, the optimum electrolyte composition of a dialysis solution is that which best serves the homeostatic needs of the body. Comparing the transperitoneal removal of electrolytes by conventional PD solutions (CPDSs) with that by normal kidneys, it is evident that peritoneal removal is in the lower range of what can be considered "normal." Given the electrolyte composition of CPDSs and a total dwell volume of 4 exchanges of 2 L each, approximately 90 mmol NaCl, 40 mmol K(+), 10 - 15 mmol HPO(4)(-) and 1 - 2 mmol Ca(2+) can be removed daily [plus 1 L ultrafiltration (UF)]. Na(+), Ca(2+), and Mg(2+) are supplied in CPDSs in concentrations close to their plasma concentrations, which makes their removal almost entirely dependent on UF. In UF failure (UFF), plasma levels of the foregoing ions will tend to rise, producing a higher diffusion gradient to compensate for their defective UF removal. Peritoneal removal of HCO(3)(-), HPO(4)(-), and K(+) are usually quite efficient because of the zero CPDS concentrations of these ions. Approximately 150 mmol HCO(3)(-) is lost daily with CPDSs, compensated for by the addition of 30 - 40 mmol/L lactate, or, with the use of multi-compartment bags, bicarbonate instead. However, a mixture of bicarbonate and lactate should be preferred as a buffer, to avoid intracellular acidosis from high levels of pCO(2) in the dialysis fluid. For patients on continuous ambulatory peritoneal dialysis (CAPD) without UFF and with some residual renal function, PD fluid concentrations of Na(+) 130 - 133 mmol/L, Ca(2+) 1.25 - 1.35 mmol/L, and Mg(2+) 0.25 - 0.3 mmol/L seem appropriate. With reduced UF after a few years of PD, the removal of fluid and electrolytes often becomes deficient. Dietary salt restriction can be prescribed, but it is hard to implement. The use of low-Na(+) solution (LNa) is a potential alternative. The reduction in osmolality resulting from Na(+) removal in LNa should preferably be compensated by the addition of glucose (G). In a recent study, a regimen including 1 LNa exchange daily (Na(+) 115 mmol/L) in a G-compensated solution showed very promising effects on blood pressure and fluid status. However, large-scale randomized controlled studies have to be performed to definitively settle the role of LNa in volume-overloaded patients.
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| 13. |
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| 14. |
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| 15. |
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| 16. |
- Venturoli, Daniele, et al.
(författare)
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The variability in ultrafiltration achieved with icodextrin, possibly explained.
- 2009
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Ingår i: Peritoneal Dialysis International. - 1718-4304. ; 29:4, s. 415-421
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A recent study by Jeloka et al. (Perit Dial Int 2006; 26:336-40) highlighted the high variability in maximum ultrafiltered volume (UF(max)) and the corresponding dwell time (t(max)) obtained using 7.5% icodextrin solution. We aimed to pinpoint the possible sources of this phenomenon by simulating the icodextrin ultrafiltration (UF) profiles according to the three-pore model of peritoneal transport. Method: The individual UF time courses observed in the study by Jeloka et al. (n = 29) were first characterized by linear and quadratic regression. We were then able to identify four main patterns. These were then adapted to UF profiles generated by the three-pore model by systematically altering the values of some model parameters, namely, the mass transfer area coefficient (MTAC or PS) for icodextrin/glucose, the peritoneal UF coefficient (LpS), the plasma colloid osmotic pressure gradient (DeltaPi), and the macromolecular clearance out of the peritoneal cavity (Cl(LF)). RESULTS: Modifications in the PS values caused only marginal variations in UF(max) and t(max), while more significant changes were produced by altering LpS and Cl(LF). However, far more evident was the importance of changes in DeltaPi. In fact, lowering DeltaPi to 14 mmHg caused a steady increase in UF with 10 - 14 hour dwells. On the contrary, the UF profiles became nearly "flat" when DeltaPi was increased to 30 mmHg. The parallel shifts induced by altering icodextrin metabolite concentrations did not markedly influence UF(max) or t(max). CONCLUSION: The UF pattern in icodextrin dwells seem to be mainly determined by the plasma colloid osmotic pressure, while only moderate changes can be seen with alterations in LpS and Cl(LF). The result is not completely unexpected considering that icodextrin acts by inducing a strong colloid osmotic gradient. A number of clinical studies would be needed, however, in order to prove this hypothesis.
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| 17. |
- Venturoli, Daniele, et al.
(författare)
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Validation by computer simulation of two indirect methods for quantification of free water transport in peritoneal dialysis.
- 2005
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Ingår i: Peritoneal Dialysis International. - 1718-4304. ; 25:1, s. 77-84
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In peritoneal dialysis, approximately 40% of the total osmotic ultrafiltration (UF) induced by glucose can be predicted to be due to "free" water transport across aquaporin-1 (APQ-1). Theoretically, it would be possible to assess the fraction of free water transport in the early phase of a hypertonic dwell, when UF rate is high and the relative contribution of Na+ diffusion is low. La Milia et al. [La Milia V. et al. Fast-fast peritoneal equilibration test (FAST-FAST-PET): a simple method for peritoneal hydraulic permeability study [Abstract]. Nephrol Dial Transplant 2002; 17 (Suppl 1):17-18] suggested a technique to assess sodium-associated water transport based on sodium removal (Na+R) divided by the plasma Na+ concentration during a "fast-fast" (60 minute) peritoneal equilibration test (PET) for 3.86% glucose, yielding an estimate of the UF passing through the small pores (UFSP). Free water transport (UF through ultrasmall pores; UFUSP) was obtained by subtracting UFSP from total UF. Although peritoneal Na+ transport is almost totally convective, this technique will slightly overestimate small-pore UF due to the presence of some small-pore Na+ diffusion from the circulation during the dwell. A way of dealing with this problem was presented recently by Smit (Smit W. et al. Quantification of free water transport in peritoneal dialysis. Kidney Int 2004; 66:849-854). METHODS: In the present study we used the three-pore model of peritoneal transport to predict the degree of overestimation of UFSP for the technique presented by La Milia et al., and any potential deviations from theory for the technique presented by Smit et at. Simulations were performed under ordinary conditions and during simulated UF failure for 3.86% glucose. The fractional UF coefficient accounted for by APQ-1 was set at 2%. RESULTS: Estimating the UFSP from the sodium-associated water transport according to the method by La Milia et al. consistently overestimated UFSP and underestimated UFUSP. These errors were, however, minimal for dwells lasting between 30 and 80 minutes. The technique by Smit et al. to calculate aquaporin-mediated water flow (UFUSP), using an elaborate correction for Na+ diffusion from the circulation during the dwell, seemed accurate in most situations but, in general, tended to moderately overestimate UFUSP at early dwell times (<30 minutes) and underestimate UFUSP at long dwell times (4 hours). CONCLUSIONS: The technique presented by La Milia et at. to calculate free water transport during a fast-fast PET was found to be surprisingly accurate, although the procedure would further improve by the introduction of a correction algorithm. The technique by Smit is even more accurate for dwells up to 4 hours' duration. However, since the Smit technique is elaborate, it is less practical for routine determinations of aquaporin-mediated water transport in peritoneal dialysis.
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| 18. |
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| 19. |
- Weiss, Lars, et al.
(författare)
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BIOCOMPATIBILITY AND TOLERABILITY OF A PURELY BICARBONATE-BUFFERED PERITONEAL DIALYSIS SOLUTION
- 2009
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Ingår i: Peritoneal Dialysis International. - 1718-4304 .- 0896-8608. ; 29:6, s. 647-655
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Tidskriftsartikel (refereegranskat)abstract
- Background: Novel peritoneal dialysis solutions are characterized by a minimal content of glucose degradation products and a neutral pH. Many studies have shown the biocompatibility of neutral lactate-buffered solutions; however, until now, the effect of purely bicarbonate-buffered solutions has not been intensively studied in vivo. Methods: This study was an open label, prospective, crossover multicenter trial to investigate the biocompatibility of a purely bicarbonate-buffered solution (bicPDF) by measuring biocompatibility parameters such as cancer antigen 125 (CA125) in peritoneal effluent. 55 patients were enrolled in the study. After a 2-week run-in phase, 53 patients could be randomized into 2 groups, starting with either standard lactate-buffered peritoneal dialysis fluid (SPDF) for 12 weeks (phase 1) and then switching to bicPDF for 12 weeks (phase 2), or vice versa. Overnight peritoneal effluents were collected at baseline and at the end of phases 1 and 2 and were tested for CA125, hyaluronic acid, vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-alpha), interleukin 6 (IL-6), interferon gamma (IFN gamma), and transforming growth factor-beta 1 (TGF-beta 1). Total ultrafiltration and residual renal function were also assessed. At the end of the study, pain during fluid exchange and dwell was evaluated using special questionnaires. Results: 34 patients completed the study; 27 of them provided data for analysis of the biocompatibility parameters. CA125 levels in overnight effluent were significantly higher with bicPDF (61.9 +/- 33.2 U/L) than with SPDF (18.6 +/- 18.2 U/L, p < 0.001). Hyaluronic acid levels were significantly lower after the use of bicPDF (185.0 +/- 119.6 ng/mL) than after SPDF (257.4 +/- 174.0 ng/mL, p = 0.013). Both TNF-alpha and TGF-beta 1 showed higher levels with the use of bicPDF than with SPDF. No differences were observed for IL-6, VEGF, or IFN gamma levels. We observed an improvement in the glomerular filtration rate with the use of bicPDF but no differences were observed for total fluid loss. Pain scores could be analyzed in 23 patients: there was no difference between the solutions. Conclusions: The use of a purely bicarbonate-buffered low-glucose degradation product solution significantly changes most of the peritoneal effluent markers measured, suggesting an improvement in peritoneal membrane integrity. Additionally, it seems to have a positive effect on residual renal function.
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| 20. |
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