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Conference Paper: Low- verus conventional-level of glucose peritoneal dialysis regimes: comparison of inflammatory and fibrotic mediators in peritoneal dialysate

TitleLow- verus conventional-level of glucose peritoneal dialysis regimes: comparison of inflammatory and fibrotic mediators in peritoneal dialysate
Authors
Issue Date2011
Citation
World Congress of Nephrology (WCN) 2011, Vancouver, Canada, 8-12 April 2011. How to Cite?
AbstractINTRODUCTION AND AIMS: New peritoneal dialysis fluids (PDF) such as Extraneal, Nutrineal, and Physioneal offer the advantages of reduced glucose exposure and improved biocompatibility, compared with conventional glucose-based PDF. We investigated the effect of these new PDFs on peritoneal inflammation, fibrosis, and clinical parameters. METHODS: Eighty new PD patients were randomized to receive PD treatment with either a low-glucose regimen comprising Physioneal, Nutrineal, and Extraneal (PEN) or with conventional glucose-based dialysate (Dianeal) (Controls) for 12 months. PDF and serum samples were collected at baseline then every 6 months, and the levels of hyaluronan (HA), nitric oxide (NO) and CA125 determined. Residual renal function, dialysis adequacy and peritoneal solute transport rate were also measured. RESULTS: Dialysate CA125 levels increased over time in PEN group, and were significantly higher than those in Controls (p<0.01). Dialysate NO level decreased in the PEN group but rose in Controls over the 12 month period (p<0.05). Both groups showed increasing dialysate HA levels over time, but in the PEN group this increase occurred predominantly in the first 6 months, and dialysate HA levels remained relatively stable subsequently. PEN group showed significantly increased ultrafiltration over time (p=0.05), while residual renal function was comparable in the two groups (p=0.186). Mean total Kt/V at 12-month was 2.44 (2.17-2.70) and 2.18 (1.99-2.36) in the PEN group and Controls respectively (p=0.148). CONCLUSIONS: The data on CA125 and NO suggest better preservation of peritoneal mesothelial cell mass and reduced peritoneal inflammation in patients treated with the PEN regimen compared with Controls on Dianeal dialysis. The serial profile of dialysate HA levels also suggests an amelioration in peritoneal inflammation with increasing duration of PEN dialysis. These data imply improved peritoneal preservation with long-term PEN dialysis compared with conventional PDF.
DescriptionSession: Peritoneal dialysis: SU380
Persistent Identifierhttp://hdl.handle.net/10722/135919

 

DC FieldValueLanguage
dc.contributor.authorMa, MKMen_US
dc.contributor.authorYung, Sen_US
dc.contributor.authorYim, ASYen_US
dc.contributor.authorNg, CKFen_US
dc.contributor.authorTang, CSOen_US
dc.contributor.authorLui, SLen_US
dc.contributor.authorChan, TMen_US
dc.date.accessioned2011-07-27T01:59:42Z-
dc.date.available2011-07-27T01:59:42Z-
dc.date.issued2011en_US
dc.identifier.citationWorld Congress of Nephrology (WCN) 2011, Vancouver, Canada, 8-12 April 2011.en_US
dc.identifier.urihttp://hdl.handle.net/10722/135919-
dc.descriptionSession: Peritoneal dialysis: SU380-
dc.description.abstractINTRODUCTION AND AIMS: New peritoneal dialysis fluids (PDF) such as Extraneal, Nutrineal, and Physioneal offer the advantages of reduced glucose exposure and improved biocompatibility, compared with conventional glucose-based PDF. We investigated the effect of these new PDFs on peritoneal inflammation, fibrosis, and clinical parameters. METHODS: Eighty new PD patients were randomized to receive PD treatment with either a low-glucose regimen comprising Physioneal, Nutrineal, and Extraneal (PEN) or with conventional glucose-based dialysate (Dianeal) (Controls) for 12 months. PDF and serum samples were collected at baseline then every 6 months, and the levels of hyaluronan (HA), nitric oxide (NO) and CA125 determined. Residual renal function, dialysis adequacy and peritoneal solute transport rate were also measured. RESULTS: Dialysate CA125 levels increased over time in PEN group, and were significantly higher than those in Controls (p<0.01). Dialysate NO level decreased in the PEN group but rose in Controls over the 12 month period (p<0.05). Both groups showed increasing dialysate HA levels over time, but in the PEN group this increase occurred predominantly in the first 6 months, and dialysate HA levels remained relatively stable subsequently. PEN group showed significantly increased ultrafiltration over time (p=0.05), while residual renal function was comparable in the two groups (p=0.186). Mean total Kt/V at 12-month was 2.44 (2.17-2.70) and 2.18 (1.99-2.36) in the PEN group and Controls respectively (p=0.148). CONCLUSIONS: The data on CA125 and NO suggest better preservation of peritoneal mesothelial cell mass and reduced peritoneal inflammation in patients treated with the PEN regimen compared with Controls on Dianeal dialysis. The serial profile of dialysate HA levels also suggests an amelioration in peritoneal inflammation with increasing duration of PEN dialysis. These data imply improved peritoneal preservation with long-term PEN dialysis compared with conventional PDF.-
dc.languageengen_US
dc.relation.ispartofWorld Congress of Nephrologyen_US
dc.titleLow- verus conventional-level of glucose peritoneal dialysis regimes: comparison of inflammatory and fibrotic mediators in peritoneal dialysateen_US
dc.typeConference_Paperen_US
dc.identifier.emailYung, S: ssyyung@hku.hken_US
dc.identifier.emailYim, ASY: anndyim@hku.hken_US
dc.identifier.emailNg, CKF: kfchris@hku.hken_US
dc.identifier.emailTang, CSO: csotang@HKUCC.hku.hken_US
dc.identifier.emailLui, SL: sllui@hku.hken_US
dc.identifier.emailChan, TM: dtmchan@hku.hken_US
dc.identifier.authorityYung, S=rp00455en_US
dc.identifier.authorityChan, TM=rp00394en_US
dc.identifier.hkuros188589en_US
dc.description.otherThe 2011 World Congress of Nephrology (WCN 2011), Vancouver, Canada, 8-12 April 2011.-

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