THE EFFECT OF LOW-GDP SOLUTION ON ULTRAFILTRATION AND SOLUTE TRANSPORT IN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS PATIENTS

Title
THE EFFECT OF LOW-GDP SOLUTION ON ULTRAFILTRATION AND SOLUTE TRANSPORT IN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS PATIENTS
Author(s)
도준영조규향박종원윤경우김용림[김용림]
Keywords
GLUCOSE-DEGRADATION-PRODUCTS; RESIDUAL RENAL-FUNCTION; MESOTHELIAL CELLS; PD FLUID; BICARBONATE/LACTATE; 1-YEAR; TRIAL; BIOCOMPATIBILITY; ICODEXTRIN; MEMBRANE
Issue Date
201307
Publisher
MULTIMED INC
Citation
PERITONEAL DIALYSIS INTERNATIONAL, v.33, no.4, pp.382 - 390
Abstract
Background: Several studies have reported benefits for human peritoneal mesothelial cell function of a neutral-pH dialysate low in glucose degradation products (GDPs). However, the effects of low-GDP solution on ultrafiltration (UF), transport of solutes, and control of body water remain elusive. We therefore investigated the effect of low-GDP solution on UF, solute transport, and control of body water. Methods: Among 79 new continuous ambulatory peritoneal dialysis (CAPD) patients, 60 completed a 12-month protocol (28 in a lactate-based high-GDP solution group, 32 in a lactate-based low-GDP solution group). Clinical indices-including 24-hour UF volume (UFV), 24-hour urine volume (UV), residual renal function, and dialysis adequacy-were measured at months 1, 6, and 12. At months 1, 6, and 12, UFV, glucose absorption, 4-hour dialysate-to-plasma (D/P) creatinine, and 1-hour D/P Na+ were assessed during a modified 4.25% peritoneal equilibration test (PET). Body composition by bioelectric impedance analysis was measured at months 1 and 12 in 26 CAPD patients. Results: Daily UFV was lower in the low-GDP group. Despite similar solute transport and aquaporin function, the low-GDP group also showed lower UFV and higher glucose absorption during the PET. Factors associated with UFV during the PET were lactate-based high-GDP solution and 1-hour D/P Na+. No differences in volume status and obesity at month 12 were observed, and improvements in hypervolemia were equal in both groups. Conclusions: Compared with the high-GDP group, the low-GDP group had a lower UFV during a PET and a lower daily UFV during the first year after peritoneal dialysis initiation. Although the low-GDP group had a lower daily UFV, no difficulties in controlling edema were encountered.
URI
http://hdl.handle.net/YU.REPOSITORY/29443http://dx.doi.org/10.3747/pdi.2011.00279
ISSN
0896-8608
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의과대학 > 내과학교실 > Articles
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