Document Detail


Neutral solution low in glucose degradation products is associated with less peritoneal fibrosis and vascular sclerosis in patients receiving peritoneal dialysis.
MedLine Citation:
PMID:  23123670     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The effects of novel biocompatible peritoneal dialysis (PD) solutions on human peritoneal membrane pathology have yet to be determined. Quantitative evaluation of human peritoneal biopsy specimens may reveal the effects of the new solutions on peritoneal membrane pathology. ♢
METHODS: Peritoneal specimens from 24 PD patients being treated with either acidic solution containing high-glucose degradation products [GDPs (n = 12)] or neutral solution with low GDPs (n = 12) were investigated at the end of PD. As controls, pre-PD peritoneal specimens, obtained from 13 patients at PD catheter insertion, were also investigated. The extent of peritoneal fibrosis, vascular sclerosis, and advanced glycation end-product (AGE) accumulation were evaluated by quantitative or semi-quantitative methods. The average densities of CD31-positive vessels and podoplanin-positive lymphatic vessels were also determined. ♢
RESULTS: Peritoneal membrane fibrosis, vascular sclerosis, and AGE accumulation were significantly suppressed in the neutral group compared with the acidic group. The neutral group also showed lower peritoneal equilibration test scores and preserved ultrafiltration volume. The density of blood capillaries, but not of lymphatic capillaries, was significantly increased in the neutral group compared with the acidic and pre-PD groups. ♢
CONCLUSIONS: Neutral solutions with low GDPs are associated with less peritoneal membrane fibrosis and vascular sclerosis through suppression of AGE accumulation. However, contrary to expectation, blood capillary density was increased in the neutral group. The altered contents of the new PD solutions modified peritoneal membrane morphology and function in patients undergoing PD.
Authors:
Kunio Kawanishi; Kazuho Honda; Misao Tsukada; Hideaki Oda; Kosaku Nitta
Publication Detail:
Type:  Journal Article     Date:  2012-11-01
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  33     ISSN:  1718-4304     ISO Abbreviation:  Perit Dial Int     Publication Date:    2013 May-Jun
Date Detail:
Created Date:  2013-05-10     Completed Date:  2014-02-24     Revised Date:  2014-05-08    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  242-51     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Bicarbonates / analysis
Biocompatible Materials
Blood Vessels / pathology
Capillaries / pathology
Dialysis Solutions / chemistry*
Female
Glucose / metabolism*
Glycosylation End Products, Advanced / metabolism*
Humans
Kidney Failure, Chronic / therapy
Male
Middle Aged
Peritoneal Dialysis*
Peritoneal Fibrosis
Peritoneum / metabolism
Sclerosis
Ultrafiltration
Chemical
Reg. No./Substance:
0/Bicarbonates; 0/Biocompatible Materials; 0/Dialysis Solutions; 0/Glycosylation End Products, Advanced; IY9XDZ35W2/Glucose
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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