| Short-term effects of a new bicarbonate/lactate-buffered and conventional peritoneal dialysis fluid on peritoneal and systemic inflammation in CAPD patients: a randomized controlled study. | |
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MedLine Citation:
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PMID: 18178947 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study was designed to compare the local peritoneal and systemic inflammatory effects of a conventional lactate-based (Lac) peritoneal dialysis (PD) solution and a new biocompatible bicarbonate/lactate-based (Bic/Lac) solution having low concentration of glucose degradation products. METHODS: 26 stable, prevalent PD patients were enrolled in this prospective study. They sequentially underwent 3 months of therapy with the Lac solution and 3 months with the Bic/Lac solution in a randomized order. Flow cytometry was used to measure the expression of inflammatory molecules on peritoneal cells in overnight effluent collected at the end of each study period. RESULTS: 21 patients successfully completed the study. Mean fluorescence intensity of human leukocyte antigen (HLA)-DR and CD14 expression by macrophages were not different between Lac and Bic/Lac. The peritoneal appearance rate of cancer antigen 125 (kU/minute) was 68 +/- 37 with Lac and 133 +/- 66 with Bic/Lac (p < 0.001), and of interleukin (IL)-6 (ng/minute), 0.28 +/- 0.2 with Lac and 0.18 +/- 0.16 with Bic/Lac (p = 0.014). HLA-DR macrophage expression and IL-6 peritoneal appearance rates did not correlate. Serum concentrations with Lac and Bic/Lac were, for IL-6, 3.49 +/- 2.28 and 3.72 +/- 2.46 ng/L (p = 0.17), and for high-sensitivity C-reactive protein, 2.31 +/- 2.98 and 2.71 +/- 3.31 mg/L (p = 0.32) respectively. The concentration of effluent macrophages (x10(6)/L) with Lac was 1.6 +/- 1.6 and with Bic/Lac 2.6 +/- 3.3 (p = 0.07). CONCLUSIONS: We conclude that, although there was a significant reduction in peritoneal IL-6 in patients using Bic/Lac solution, systemic levels of inflammatory markers did not differ between the two solutions and no changes were present in macrophage surface activation markers, suggesting perhaps a less important role of peritoneal macrophages in the intraperitoneal chronic inflammatory process. The number of effluent macrophages tended to be higher in patients using the Bic/Lac solution, possibly contributing to improved intraperitoneal defense. |
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Authors:
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Jernej Pajek; Radoslav Kveder; Andrej Bren; Andrej Gucek; Alojz Ihan; Josko Osredkar; Bengt Lindholm |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis Volume: 28 ISSN: 0896-8608 ISO Abbreviation: Perit Dial Int Publication Date: 2008 Jan-Feb |
Date Detail:
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Created Date: 2008-01-07 Completed Date: 2008-06-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8904033 Medline TA: Perit Dial Int Country: Canada |
Other Details:
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Languages: eng Pagination: 44-52 Citation Subset: IM |
Affiliation:
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Department of Nephrology, University Medical Center Ljubljana, Slovenia. jernej.pajek@mf.uni-lj.si |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Ascitic Fluid / metabolism Bicarbonates / pharmacology* Buffers C-Reactive Protein / metabolism CA-125 Antigen / metabolism Cross-Over Studies Dialysis Solutions / pharmacology* Female Flow Cytometry Humans Interleukin-6 / metabolism Lactic Acid / pharmacology* Macrophages / metabolism Male Middle Aged Peritoneal Dialysis, Continuous Ambulatory / methods* Peritonitis / physiopathology* Prospective Studies Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Bicarbonates; 0/Buffers; 0/CA-125 Antigen; 0/Dialysis Solutions; 0/Interleukin-6; 50-21-5/Lactic Acid; 9007-41-4/C-Reactive Protein |
| Comments/Corrections | |
Comment In:
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Perit Dial Int. 2008 Jan-Feb;28(1):28-31
[PMID:
18178944
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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