The clinical usefulness of peritoneal dialysis fluids with neural pH and low glucose degradation product concentration: An open randomized prospective trial

Hoon Young Choi, Dong Ki Kim, Tae Hee Lee, Sung Jin Moon, Seung Hyeok Han, Jung Eun Lee, Beom Seok Kim, Hyeong Cheon Park, Kyu Hun Choi, Sung Kyu Ha, Dae Suk Han, Ho Yung Lee

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Abstract

◆ Background: Long-term peritoneal dialysis (PD) is associated with the development of various structural and functional changes to the peritoneal membrane when bioincompatibie conventional peritoneal dialysis fluids (PDFs) are used. In this study, we looked at patients that were treated with conventional PDFs and then changed to novel biocompatible PDFs with a neutral pH and a tow concentration of glucose degradation products (GDPs) to investigate whether this change could result in the arrest or reversal of peritoneal membrane deterioration. ◆ Methods: In an open label, randomized prospective trial, the clinical effects of conventional PDFs and biocompatible PDFs with neutral pH and very low concentration of GDPs were compared in 104 patients equally divided between both study PDFs. Blood and effluent dialysate samples, peritoneal equilibration tests, and adequacy evaluation were undertaken at baseline, 4, 8, and 12 months. The target variables were the ratio of dialysate-to-plasma (D/P) creatinine, peritoneal ultrafiltration, residual renal function, dialysis adequacy indices, and effluent cancer antigen 125 (CA125). ◆ Results: D/P creatinine values were not different in the two groups. Peritoneal ultrafiltration was significantly higher in the low-GDP PDF group than in the conventional PDF group at all follow-up times (4 months: 9.1 ± 4.3 vs 6.0 ± 3.0; 8 months: 8.3 ± 3.4 vs 6.0 ± 3.0; 12 months: 8.9 ± 3.3 vs 6.1 ± 3.3 mL/g dextrose/day; p < 0.05). Peritoneal. Kt/V urea values and total weekly Kt/V urea values at 4 monthswere significantly higher in the low-GDP PDF group than in the conventional PDF group. Residual renal function was not statistically significant. Effluent CA125 levels were significantly higher in the low-GDP PDF group at all follow-up visits (4 months: 37.8 ± 20.8 vs 22.0 ± 9.5; 8 months: 41.2 ± 20.3 vs 25.9 ± 11.3; 12 months: 40.4 ± 21.4 vs 28.6 ± 13.0U/mL; p < 0.05). Among anuric patients, peritoneal ultrafiltration at 4, 8, and 12 months, total weekly Kt/V at 4 and 8 months, and CA125 levels at all follow-up visits were significantly higher in patients treated with Low-GDP PDF than those treated with conventional PDF. However, among anuric patients, D/P creatinine showed no significant differences between the low-GDP PDF group and the conventional PDF group. ◆ Conclusion: The use oi biocompatible PDFs with neutral pH and low GDP concentration can contribute to improvement of peritoneal ultrafiltration and peritoneal effluent CA125 level, an indicator of peritoneal membrane integrity in PD patients.

Original languageEnglish
Pages (from-to)174-182
Number of pages9
JournalPeritoneal Dialysis International
Volume28
Issue number2
Publication statusPublished - 2008 Mar 1

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Ascitic Fluid
Peritoneal Dialysis
Glucose
Dialysis Solutions
Ultrafiltration
Antigens
Creatinine
Membranes
Urea
Neoplasms

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Choi, Hoon Young ; Kim, Dong Ki ; Lee, Tae Hee ; Moon, Sung Jin ; Han, Seung Hyeok ; Lee, Jung Eun ; Kim, Beom Seok ; Park, Hyeong Cheon ; Choi, Kyu Hun ; Ha, Sung Kyu ; Han, Dae Suk ; Lee, Ho Yung. / The clinical usefulness of peritoneal dialysis fluids with neural pH and low glucose degradation product concentration : An open randomized prospective trial. In: Peritoneal Dialysis International. 2008 ; Vol. 28, No. 2. pp. 174-182.
@article{b28025a195474ae59f0754fec3b435d5,
title = "The clinical usefulness of peritoneal dialysis fluids with neural pH and low glucose degradation product concentration: An open randomized prospective trial",
abstract = "◆ Background: Long-term peritoneal dialysis (PD) is associated with the development of various structural and functional changes to the peritoneal membrane when bioincompatibie conventional peritoneal dialysis fluids (PDFs) are used. In this study, we looked at patients that were treated with conventional PDFs and then changed to novel biocompatible PDFs with a neutral pH and a tow concentration of glucose degradation products (GDPs) to investigate whether this change could result in the arrest or reversal of peritoneal membrane deterioration. ◆ Methods: In an open label, randomized prospective trial, the clinical effects of conventional PDFs and biocompatible PDFs with neutral pH and very low concentration of GDPs were compared in 104 patients equally divided between both study PDFs. Blood and effluent dialysate samples, peritoneal equilibration tests, and adequacy evaluation were undertaken at baseline, 4, 8, and 12 months. The target variables were the ratio of dialysate-to-plasma (D/P) creatinine, peritoneal ultrafiltration, residual renal function, dialysis adequacy indices, and effluent cancer antigen 125 (CA125). ◆ Results: D/P creatinine values were not different in the two groups. Peritoneal ultrafiltration was significantly higher in the low-GDP PDF group than in the conventional PDF group at all follow-up times (4 months: 9.1 ± 4.3 vs 6.0 ± 3.0; 8 months: 8.3 ± 3.4 vs 6.0 ± 3.0; 12 months: 8.9 ± 3.3 vs 6.1 ± 3.3 mL/g dextrose/day; p < 0.05). Peritoneal. Kt/V urea values and total weekly Kt/V urea values at 4 monthswere significantly higher in the low-GDP PDF group than in the conventional PDF group. Residual renal function was not statistically significant. Effluent CA125 levels were significantly higher in the low-GDP PDF group at all follow-up visits (4 months: 37.8 ± 20.8 vs 22.0 ± 9.5; 8 months: 41.2 ± 20.3 vs 25.9 ± 11.3; 12 months: 40.4 ± 21.4 vs 28.6 ± 13.0U/mL; p < 0.05). Among anuric patients, peritoneal ultrafiltration at 4, 8, and 12 months, total weekly Kt/V at 4 and 8 months, and CA125 levels at all follow-up visits were significantly higher in patients treated with Low-GDP PDF than those treated with conventional PDF. However, among anuric patients, D/P creatinine showed no significant differences between the low-GDP PDF group and the conventional PDF group. ◆ Conclusion: The use oi biocompatible PDFs with neutral pH and low GDP concentration can contribute to improvement of peritoneal ultrafiltration and peritoneal effluent CA125 level, an indicator of peritoneal membrane integrity in PD patients.",
author = "Choi, {Hoon Young} and Kim, {Dong Ki} and Lee, {Tae Hee} and Moon, {Sung Jin} and Han, {Seung Hyeok} and Lee, {Jung Eun} and Kim, {Beom Seok} and Park, {Hyeong Cheon} and Choi, {Kyu Hun} and Ha, {Sung Kyu} and Han, {Dae Suk} and Lee, {Ho Yung}",
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Choi, HY, Kim, DK, Lee, TH, Moon, SJ, Han, SH, Lee, JE, Kim, BS, Park, HC, Choi, KH, Ha, SK, Han, DS & Lee, HY 2008, 'The clinical usefulness of peritoneal dialysis fluids with neural pH and low glucose degradation product concentration: An open randomized prospective trial', Peritoneal Dialysis International, vol. 28, no. 2, pp. 174-182.

The clinical usefulness of peritoneal dialysis fluids with neural pH and low glucose degradation product concentration : An open randomized prospective trial. / Choi, Hoon Young; Kim, Dong Ki; Lee, Tae Hee; Moon, Sung Jin; Han, Seung Hyeok; Lee, Jung Eun; Kim, Beom Seok; Park, Hyeong Cheon; Choi, Kyu Hun; Ha, Sung Kyu; Han, Dae Suk; Lee, Ho Yung.

In: Peritoneal Dialysis International, Vol. 28, No. 2, 01.03.2008, p. 174-182.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The clinical usefulness of peritoneal dialysis fluids with neural pH and low glucose degradation product concentration

T2 - An open randomized prospective trial

AU - Choi, Hoon Young

AU - Kim, Dong Ki

AU - Lee, Tae Hee

AU - Moon, Sung Jin

AU - Han, Seung Hyeok

AU - Lee, Jung Eun

AU - Kim, Beom Seok

AU - Park, Hyeong Cheon

AU - Choi, Kyu Hun

AU - Ha, Sung Kyu

AU - Han, Dae Suk

AU - Lee, Ho Yung

PY - 2008/3/1

Y1 - 2008/3/1

N2 - ◆ Background: Long-term peritoneal dialysis (PD) is associated with the development of various structural and functional changes to the peritoneal membrane when bioincompatibie conventional peritoneal dialysis fluids (PDFs) are used. In this study, we looked at patients that were treated with conventional PDFs and then changed to novel biocompatible PDFs with a neutral pH and a tow concentration of glucose degradation products (GDPs) to investigate whether this change could result in the arrest or reversal of peritoneal membrane deterioration. ◆ Methods: In an open label, randomized prospective trial, the clinical effects of conventional PDFs and biocompatible PDFs with neutral pH and very low concentration of GDPs were compared in 104 patients equally divided between both study PDFs. Blood and effluent dialysate samples, peritoneal equilibration tests, and adequacy evaluation were undertaken at baseline, 4, 8, and 12 months. The target variables were the ratio of dialysate-to-plasma (D/P) creatinine, peritoneal ultrafiltration, residual renal function, dialysis adequacy indices, and effluent cancer antigen 125 (CA125). ◆ Results: D/P creatinine values were not different in the two groups. Peritoneal ultrafiltration was significantly higher in the low-GDP PDF group than in the conventional PDF group at all follow-up times (4 months: 9.1 ± 4.3 vs 6.0 ± 3.0; 8 months: 8.3 ± 3.4 vs 6.0 ± 3.0; 12 months: 8.9 ± 3.3 vs 6.1 ± 3.3 mL/g dextrose/day; p < 0.05). Peritoneal. Kt/V urea values and total weekly Kt/V urea values at 4 monthswere significantly higher in the low-GDP PDF group than in the conventional PDF group. Residual renal function was not statistically significant. Effluent CA125 levels were significantly higher in the low-GDP PDF group at all follow-up visits (4 months: 37.8 ± 20.8 vs 22.0 ± 9.5; 8 months: 41.2 ± 20.3 vs 25.9 ± 11.3; 12 months: 40.4 ± 21.4 vs 28.6 ± 13.0U/mL; p < 0.05). Among anuric patients, peritoneal ultrafiltration at 4, 8, and 12 months, total weekly Kt/V at 4 and 8 months, and CA125 levels at all follow-up visits were significantly higher in patients treated with Low-GDP PDF than those treated with conventional PDF. However, among anuric patients, D/P creatinine showed no significant differences between the low-GDP PDF group and the conventional PDF group. ◆ Conclusion: The use oi biocompatible PDFs with neutral pH and low GDP concentration can contribute to improvement of peritoneal ultrafiltration and peritoneal effluent CA125 level, an indicator of peritoneal membrane integrity in PD patients.

AB - ◆ Background: Long-term peritoneal dialysis (PD) is associated with the development of various structural and functional changes to the peritoneal membrane when bioincompatibie conventional peritoneal dialysis fluids (PDFs) are used. In this study, we looked at patients that were treated with conventional PDFs and then changed to novel biocompatible PDFs with a neutral pH and a tow concentration of glucose degradation products (GDPs) to investigate whether this change could result in the arrest or reversal of peritoneal membrane deterioration. ◆ Methods: In an open label, randomized prospective trial, the clinical effects of conventional PDFs and biocompatible PDFs with neutral pH and very low concentration of GDPs were compared in 104 patients equally divided between both study PDFs. Blood and effluent dialysate samples, peritoneal equilibration tests, and adequacy evaluation were undertaken at baseline, 4, 8, and 12 months. The target variables were the ratio of dialysate-to-plasma (D/P) creatinine, peritoneal ultrafiltration, residual renal function, dialysis adequacy indices, and effluent cancer antigen 125 (CA125). ◆ Results: D/P creatinine values were not different in the two groups. Peritoneal ultrafiltration was significantly higher in the low-GDP PDF group than in the conventional PDF group at all follow-up times (4 months: 9.1 ± 4.3 vs 6.0 ± 3.0; 8 months: 8.3 ± 3.4 vs 6.0 ± 3.0; 12 months: 8.9 ± 3.3 vs 6.1 ± 3.3 mL/g dextrose/day; p < 0.05). Peritoneal. Kt/V urea values and total weekly Kt/V urea values at 4 monthswere significantly higher in the low-GDP PDF group than in the conventional PDF group. Residual renal function was not statistically significant. Effluent CA125 levels were significantly higher in the low-GDP PDF group at all follow-up visits (4 months: 37.8 ± 20.8 vs 22.0 ± 9.5; 8 months: 41.2 ± 20.3 vs 25.9 ± 11.3; 12 months: 40.4 ± 21.4 vs 28.6 ± 13.0U/mL; p < 0.05). Among anuric patients, peritoneal ultrafiltration at 4, 8, and 12 months, total weekly Kt/V at 4 and 8 months, and CA125 levels at all follow-up visits were significantly higher in patients treated with Low-GDP PDF than those treated with conventional PDF. However, among anuric patients, D/P creatinine showed no significant differences between the low-GDP PDF group and the conventional PDF group. ◆ Conclusion: The use oi biocompatible PDFs with neutral pH and low GDP concentration can contribute to improvement of peritoneal ultrafiltration and peritoneal effluent CA125 level, an indicator of peritoneal membrane integrity in PD patients.

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