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- Rippe, Bengt, et al.
(författare)
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Long-term clinical effects of a peritoneal dialysis fluid with less glucose degradation products
- 2001
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Ingår i: Kidney Int. - : Elsevier BV. ; 59:1, s. 348-357
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Glucose degradation products (GDPs) are cytotoxic in vitro and potentially toxic in vivo during peritoneal dialysis (PD). We are presenting the results of a two-year randomized clinical trial of a new PD fluid, produced in a two-compartment bag and designed to minimize heat-induced glucose degradation while producing a near neutral pH. The effects of the new fluid over two years of treatment on membrane transport characteristics, ultrafiltration (UF) capacity, and effluent markers of peritoneal membrane integrity were investigated and compared with those obtained during treatment with a standard solution. DESIGN: A two-group parallel design with 80 continuous ambulatory peritoneal dialysis patients was used. The patients were randomly assigned to either the new fluid (N = 40) or to a conventional one (N = 40), and were stratified with respect to age, diabetes, and time on PD. Peritoneal transport characteristics were assessed by the Personal Dialysis Capacity (PDCtrade mark) test at 1, 6, 12, 18, and 24 months after inclusion and by weighing the overnight bag daily. Infusion pain and handling were evaluated using a questionnaire. Peritoneal mesothelial and interstitial integrity were evaluated by analyzing overnight effluent dialysate concentrations of CA 125, hyaluronan (HA), procollagen-1-C-terminal peptide (PICP), and procollagen-3-N-terminal peptide (PIIINP) at 1, 6, 12, 18, and 24 months. RESULTS: The handling of the new two-compartment bag was considered easy, and there were no indications of increased discomfort with the new system. Furthermore, no changes in peritoneal fluid or solute transport characteristics were observed during the study period for either fluid, and neither were there any differences with regard to peritonitis incidence. However, significantly higher dialysate CA 125 (73 +/- 41 vs. 25 +/- 18 U/mL), PICP (387 +/- 163 vs. 244 +/- 81 ng/mL), and PIIINP (50 +/- 24 vs. 29 +/- 13 ng/mL) and significantly lower concentrations of HA (395 +/- 185 vs. 530 +/- 298 ng/mL) were observed in the overnight effluent during treatment with the new fluid. CONCLUSIONS: We conclude that the new fluid with a higher pH and less GDPs is safe and easy to use and has no negative effects on either the frequency of peritonitis or peritoneal transport characteristics as compared with conventional ones. Our results indicate that the new solution causes less mesothelial and interstitial damage than conventional ones; that is, it may be considered more biocompatible than a number of conventional PD solutions currently in use.
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| 3. |
- Simonsen, I, et al.
(författare)
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Diffusion on complex networks: a way to probe their large-scale topological structures
- 2004
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Ingår i: Proceedings of the XVIII Max Born Symposium @'Statistical Physics outside Physics@' (Physica A: Statistical Mechanics and its Applications). - : Elsevier BV. - 0378-4371. ; 336:1-2, s. 163-173
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Konferensbidrag (refereegranskat)abstract
- A diffusion process on complex networks is introduced in order to uncover their large-scale topological structures. This is achieved by focusing on the slowest decaying diffusive modes of the network. The proposed procedure is applied to real-world networks like a friendship network of known modular structure, and an Internet routing network. For the friendship network, its known structure is well reproduced. In case of the Internet, where the structure is far less well known, one indeed finds a modular structure, and modules can roughly be associated with individual countries. Quantitatively, the modular structure of the Internet manifests itself in an approximately 10 times larger participation ratio of its slowest decaying modes as compared to the null model-a random scale-free network. The extreme edges of the Internet are found to correspond to Russian and US military sites. (C) 2004 Elsevier B.V. All rights reserved.
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