BIOCOMPATIBILITY AND TOLERABILITY OF A PURELY BICARBONATE-BUFFERED PERITONEAL DIALYSIS SOLUTION

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BIOCOMPATIBILITY AND TOLERABILITY OF A PURELY BICARBONATE-BUFFERED PERITONEAL DIALYSIS SOLUTION

Weiss, Lars (author): Central Sjukhuset, Karlstad

Stegmayr, Bernd (author): Umeå universitet,Medicin,University Sjukhuset, Umeå

Malmsten, Gudrun (author): University Sjukhuset, Örebro

Tejde, Mattias (author): Falu Lasarett

Hadimeri, Henrik (author): Hoglandsjukhuset Eksjoklinikerna

Siegert, Carl E. (author): Lucas Andreas Ziekenhuis

Ahlmen, Jarl (author): Karnsjukhuset, Skovde

Larsson, Rutger (author): Östergötlands Läns Landsting,Njurmedicinska kliniken US,Landstinget i Östergötland

Ingman, Bo (author): Sunderby Sjukhus, Luleå

Simonsen, Ole (author): Lund University,Lunds universitet,Njurmedicin,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Nephrology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,University Sjukhuset, Lund

van Hamersvelt, Henk W. (author): University Med Centre Nijmegen

Johansson, Ann C (author): University Sjukhus, Malmö

Hylander, Britta (author): Karolinska Institutet,Karolinska Sjukhuset

Mayr, Michael (author): University Basel Hospital

Nilsson, Per-Henrik (author): Central Lasarettet, Vaxjö

Andersson, Per O. (author): Östergötlands Läns Landsting,Landstinget i Östergötland

De los Rios, Tatiana (author): Fresenius Med Care

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(creator_code:org_t)

2009
2009
English.
In: Peritoneal Dialysis International. - 1718-4304 .- 0896-8608. ; 29:6, s. 647-655

Related links:: http://www.pdiconnec...; show more...; http://www.pdiconnec...; https://lup.lub.lu.s...; https://urn.kb.se/re...; http://kipublication...; https://urn.kb.se/re...; show less...

Journal article (peer-reviewed)

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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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By the author/editor: Weiss, Lars; Stegmayr, Bernd; Malmsten, Gudrun; Tejde, Mattias; Hadimeri, Henrik; Siegert, Carl E.; show more...; Ahlmen, Jarl; Larsson, Rutger; Ingman, Bo; Simonsen, Ole; van Hamersvelt, ...; Johansson, Ann C; Hylander, Britta; Mayr, Michael; Nilsson, Per-Hen ...; Andersson, Per O ...; De los Rios, Tat ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Urology and Neph ...

Articles in the publication: Peritoneal Dialy ...

By the university: Lund University; Umeå University; Karolinska Institutet; Linköping University

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BIOCOMPATIBILITY AND TOLERABILITY OF A PURELY BICARBONATE-BUFFERED PERITONEAL DIALYSIS SOLUTION

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