| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Clinical Trial |
Department of Nephrology, Institute of Cardiovascular Research, Free University Hospital Amsterdam, The Netherlands.
OBJECTIVE: To study the influence of peritoneal dialysis (PD) solutions on the formation of early glycated products and advanced glycation end-products (AGEs). DESIGN AND PATIENTS: The formation of both Amadori albumin and AGEs in glucose- and icodextrin-based PD fluids was analyzed in vitro and in peritoneal effluents of continuous cyclic peritoneal dialysis (CCPD) patients. RESULTS: Albumin incubated with glucose-based PD fluids showed a time- and glucose concentration-dependent formation of Amadori albumin and AGEs. Aminoguanidine completely inhibited AGE but not Amadori albumin formation. Albumin incubated in icodextrin resulted in the lowest levels of Amadori albumin and AGE. Amadori albumin levels in effluents of 24 CCPD patients (12 glucose and 12 icodextrin for their daytime dwells) were similar. Dialysate samples collected during a mass transfer area coefficient test in 16 CCPD patients (8 glucose, 8 icodextrin) showed an increase in Amadori albumin formation from baseline (p < 0.0001), without a difference between the groups. In the total group, there was a positive relationship between duration on PD and dialysate Amadori albumin concentration at 240 minutes (p = 0.03). The Amadori albumin dialysate-to-plasma (D/P) ratio at 240 minutes was 0.82+/-0.11, and its clearance amounted to 7.71+/-1.14 mL/min, while the albumin D/P ratio was 0.010+/-0.003 and its clearance was 0.089+/-0.017 mL/min. In a peritoneal biopsy of a CCPD patient, Amadori albumin was observed in the mesothelial layer and the endothelium of the peritoneum. CONCLUSIONS: Using icodextrin-based instead of glucose-based PD fluids can largely reduce the formation of Amadori albumin and AGEs. However, CCPD patients using icodextrin during daytime dwells do not have lower effluent levels of Amadori albumin and AGEs, probably due to the exposure to glucose during their nighttime exchanges. Kinetic studies suggest washout of locally produced Amadori albumin.
This article has been cited by other articles:
|
|
 |
|
  T. T. Cnossen, C. J. Konings, F. M. van der Sande, K. M. Leunissen, and J. P. Kooman Clinical effects of icodextrin in peritoneal dialysis NDT Plus, October 1, 2008; 1(suppl_4): iv18 - iv22. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. P. Schmitt, D. von Heyl, S. Rieger, K. Arbeiter, K. E. Bonzel, M. Fischbach, J. Misselwitz, A.-K. Pieper, F. Schaefer, and for the Mid European Pediatric Peritoneal Dialysis Reduced systemic advanced glycation end products in children receiving peritoneal dialysis with low glucose degradation product content Nephrol. Dial. Transplant., July 1, 2007; 22(7): 2038 - 2044. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Boulanger, M.-P. Wautier, P. Gane, C. Mariette, O. Devuyst, and J.-L. Wautier The triggering of human peritoneal mesothelial cell apoptosis and oncosis by glucose and glycoxydation products Nephrol. Dial. Transplant., September 1, 2004; 19(9): 2208 - 2216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. M. Van Hoeck, E. Rusthoven, L. Vermeylen, A. Vandesompel, B. Marescau, M. Lilien, and C. H. Schroder Nutritional effects of increasing dialysis dose by adding an icodextrin daytime dwell to Nocturnal Intermittent Peritoneal Dialysis (NIPD) in children Nephrol. Dial. Transplant., July 1, 2003; 18(7): 1383 - 1387. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. S. D. Vriese, S. Mortier, and N. H. Lameire Glucotoxicity of the peritoneal membrane: the case for VEGF Nephrol. Dial. Transplant., December 1, 2001; 16(12): 2299 - 2302. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
 |
