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Article: A combination of biocompatible peritoneal dialysis solutions and residual renal function, peritoneal transport, and inflammation markers: a randomized clinical trial

TitleA combination of biocompatible peritoneal dialysis solutions and residual renal function, peritoneal transport, and inflammation markers: a randomized clinical trial
Authors
KeywordsBiocompatibility
Continuous ambulatory peritoneal dialysis
Peritoneal dialysis fluids
Randomized controlled trial
Residual renal function
Issue Date2012
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/ajkd
Citation
American Journal of Kidney Diseases, 2012, v. 60 n. 6, p. 966-975 How to Cite?
AbstractBACKGROUND: The benefits of biocompatible peritoneal dialysis (PD) fluids, particularly for residual renal function (RRF), are controversial. Moreover, the clinical effects of a PD regimen consisting of different biocompatible PD fluids have not been fully established. STUDY DESIGN: Prospective, randomized, controlled, open-label study. SETTING and PARTICIPANTS: Patients with end-stage kidney disease newly started on continuous ambulatory PD therapy (N = 150). INTERVENTION: A 12-month intervention with 3 biocompatible PD fluids (a neutral-pH, low glucose degradation product, 1.5% glucose solution; a solution with 1.1% amino acid; and a fluid with 7.5% icodextrin) or conventional PD fluid. OUTCOMES: The primary outcome was change in RRF and daily urine volume. Secondary outcomes were peritoneal transport and inflammation markers. MEASUREMENTS: RRF, daily urine volume, serum and dialysate cytokine levels. RESULTS: RRF (3.24 +/- 1.98 vs 2.88 +/- 2.43 mL/min/1.73 m(2); P = 0.9) and rate of decline in RRF (-0.76 +/- 1.77 vs -0.91 +/- 1.92 mL/min/1.73 m(2) per year; P = 0.6) did not differ between the biocompatible- and conventional-PD-fluid groups. However, patients using the biocompatible PD fluids had better preservation of daily urine volume (959 +/- 515 vs 798 +/- 615 mL/d in the conventional group, P = 0.02 by comparison of difference in overall change by repeated-measures analysis of variance). Their dialysate-plasma creatinine ratio at 4 hours was higher at 12 months (0.78 +/- 0.13 vs 0.68 +/- 0.12; P = 0.01 for comparison of the difference in overall change by repeated-measures analysis of variance). They also had significantly higher serum levels of adiponectin and overnight spent dialysate levels of cancer antigen 125, adiponectin, and interleukin 6 (IL-6). No differences between the 2 groups were observed for serum C-reactive protein and IL-6 levels. LIMITATIONS: Unblinded, relatively short follow-up; no formal sample-size calculations. CONCLUSIONS: Use of a combination of 3 biocompatible PD fluids for 12 months compared with conventional PD fluid did not affect RRF, but was associated with better preservation of daily urine volume. The biocompatible PD fluids also lead to changes in small-solute transport and an increase in dialysate cancer antigen 125, IL-6, adiponectin, and systemic adiponectin levels, but have no effect on systemic inflammatory response. The clinical significance of these changes, while of great interest, remains to be determined by further studies.
Persistent Identifierhttp://hdl.handle.net/10722/163517
ISSN
2015 Impact Factor: 6.269
2015 SCImago Journal Rankings: 2.313
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLui, SLen_US
dc.contributor.authorYung, Sen_US
dc.contributor.authorYim, Aen_US
dc.contributor.authorWong, KMen_US
dc.contributor.authorTong, KLen_US
dc.contributor.authorWong, KSen_US
dc.contributor.authorLi, CSen_US
dc.contributor.authorAu, TCen_US
dc.contributor.authorLo, WKen_US
dc.contributor.authorHo, YWen_US
dc.contributor.authorNg, Fen_US
dc.contributor.authorTang, Cen_US
dc.contributor.authorChan, TMen_US
dc.date.accessioned2012-09-05T05:32:59Z-
dc.date.available2012-09-05T05:32:59Z-
dc.date.issued2012en_US
dc.identifier.citationAmerican Journal of Kidney Diseases, 2012, v. 60 n. 6, p. 966-975en_US
dc.identifier.issn0272-6386en_US
dc.identifier.urihttp://hdl.handle.net/10722/163517-
dc.description.abstractBACKGROUND: The benefits of biocompatible peritoneal dialysis (PD) fluids, particularly for residual renal function (RRF), are controversial. Moreover, the clinical effects of a PD regimen consisting of different biocompatible PD fluids have not been fully established. STUDY DESIGN: Prospective, randomized, controlled, open-label study. SETTING and PARTICIPANTS: Patients with end-stage kidney disease newly started on continuous ambulatory PD therapy (N = 150). INTERVENTION: A 12-month intervention with 3 biocompatible PD fluids (a neutral-pH, low glucose degradation product, 1.5% glucose solution; a solution with 1.1% amino acid; and a fluid with 7.5% icodextrin) or conventional PD fluid. OUTCOMES: The primary outcome was change in RRF and daily urine volume. Secondary outcomes were peritoneal transport and inflammation markers. MEASUREMENTS: RRF, daily urine volume, serum and dialysate cytokine levels. RESULTS: RRF (3.24 +/- 1.98 vs 2.88 +/- 2.43 mL/min/1.73 m(2); P = 0.9) and rate of decline in RRF (-0.76 +/- 1.77 vs -0.91 +/- 1.92 mL/min/1.73 m(2) per year; P = 0.6) did not differ between the biocompatible- and conventional-PD-fluid groups. However, patients using the biocompatible PD fluids had better preservation of daily urine volume (959 +/- 515 vs 798 +/- 615 mL/d in the conventional group, P = 0.02 by comparison of difference in overall change by repeated-measures analysis of variance). Their dialysate-plasma creatinine ratio at 4 hours was higher at 12 months (0.78 +/- 0.13 vs 0.68 +/- 0.12; P = 0.01 for comparison of the difference in overall change by repeated-measures analysis of variance). They also had significantly higher serum levels of adiponectin and overnight spent dialysate levels of cancer antigen 125, adiponectin, and interleukin 6 (IL-6). No differences between the 2 groups were observed for serum C-reactive protein and IL-6 levels. LIMITATIONS: Unblinded, relatively short follow-up; no formal sample-size calculations. CONCLUSIONS: Use of a combination of 3 biocompatible PD fluids for 12 months compared with conventional PD fluid did not affect RRF, but was associated with better preservation of daily urine volume. The biocompatible PD fluids also lead to changes in small-solute transport and an increase in dialysate cancer antigen 125, IL-6, adiponectin, and systemic adiponectin levels, but have no effect on systemic inflammatory response. The clinical significance of these changes, while of great interest, remains to be determined by further studies.en_US
dc.languageengen_US
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/ajkden_US
dc.relation.ispartofAmerican Journal of Kidney Diseasesen_US
dc.subjectBiocompatibilityen_US
dc.subjectContinuous ambulatory peritoneal dialysisen_US
dc.subjectPeritoneal dialysis fluidsen_US
dc.subjectRandomized controlled trialen_US
dc.subjectResidual renal functionen_US
dc.titleA combination of biocompatible peritoneal dialysis solutions and residual renal function, peritoneal transport, and inflammation markers: a randomized clinical trialen_US
dc.typeArticleen_US
dc.identifier.emailYung, S: ssyyung@hku.hken_US
dc.identifier.emailYim, A: anndyim@hku.hk-
dc.identifier.emailTang, C: csotang@hkucc.hku.hk-
dc.identifier.emailChan, TM: dtmchan@hku.hk-
dc.identifier.authorityYung, S=rp00455en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1053/j.ajkd.2012.05.018en_US
dc.identifier.pmid22835900-
dc.identifier.scopuseid_2-s2.0-84868687543en_US
dc.identifier.hkuros204913-
dc.identifier.eissn1523-6838-
dc.identifier.isiWOS:000310845100013-
dc.publisher.placeUnited Statesen_US
dc.identifier.f1000717952866-
dc.identifier.scopusauthoridChan, TM=36110804400en_US
dc.identifier.scopusauthoridTang, C=55318001600en_US
dc.identifier.scopusauthoridNg, F=7103125634en_US
dc.identifier.scopusauthoridHo, YW=7402555047en_US
dc.identifier.scopusauthoridLo, WK=7201502414en_US
dc.identifier.scopusauthoridAu, TC=55318601500en_US
dc.identifier.scopusauthoridLi, CS=7409844347en_US
dc.identifier.scopusauthoridWong, KS=55318545000en_US
dc.identifier.scopusauthoridTong, KL=7102473456en_US
dc.identifier.scopusauthoridWong, KM=55318543700en_US
dc.identifier.scopusauthoridYim, A=55318756500en_US
dc.identifier.scopusauthoridYung, S=22636568800en_US
dc.identifier.scopusauthoridLui, SL=55318150300en_US

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