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Clinical |
1 Department of Nephrology, Louis Pasteur District Hospital, Cherbourg, France;2 Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Science, Warsaw, Poland;3 Divisions of Baxter Novum and Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden
Correspondence to: P. Freida, Service de Nephrologie, Centre Hospitalier Louis
Pasteur, Cherbourg, 50102
France.
p.freida{at}ch-cherbourg.fr
Background: Fluid and sodium removal is often inadequate
in peritoneal dialysis patients with high peritoneal solute transport rate,
especially when residual renal function is declining.
Method: We studied the effects of using simultaneous
crystalloid (glucose) and colloid (icodextrin) osmotic agents on the
peritoneal transport of fluid, sodium, and other solutes during 15-hour
single-dwell exchanges using 3.86% glucose, 7.5% icodextrin, and a combination
fluid with 2.61% glucose and 6.8% icodextrin in 7 prevalent peritoneal
dialysis patients with fast peritoneal solute transport rate.
Results: The combination fluid enhanced net
ultrafiltration (mean 990 mL) and sodium removal (mean 158 mmol) compared with
7.5% icodextrin (mean net ultrafiltration 462 mL, mean net sodium removal 49
mmol). In contrast, the 3.86% glucose-based solution yielded negligible
ultrafiltration (mean -85 mL) and sodium removal (mean 16 mmol). The
combination solution resulted in significantly improved urea (+41%) and
creatinine (+26%) clearances compared with 7.5% icodextrin.
Conclusion: A solution containing both crystalloid
(glucose 2.61%) and colloid (icodextrin 6.8%) osmotic agents enhanced fluid
removal by twofold and sodium removal by threefold compared with 7.5%
icodextrin solution during a dwell of 15 hours, indicating that such a
combination solution could represent a new treatment option for anuric
peritoneal dialysis patients with high peritoneal solute transport rate.
KEY WORDS: KEY WORDS:; Ultrafiltration; icodextrin; glucose; sodium.
Received 16 October 2006; accepted 14 December 2006.
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