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Perit Dial Int 27(5): 544-553 2007
© 2007 International Society for Peritoneal Dialysis
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Clinical Sciences

PERITONEAL TRANSPORT IN PERITONEAL DIALYSIS PATIENTS USING GLUCOSE-BASED AND AMINO ACID-BASED SOLUTIONS

Anna Olszowska1, Jacek Waniewski2,3, Andrzej Werynski2, Björn Anderstam3, Bengt Lindholm3 and Zofia Wankowicz1

Department of Nephrology,1 Military Institute of Medicine; Institute of Biocybernetics and Biomedical Engineering,2 Polish Academy of Sciences, Warsaw, Poland; and Department of Clinical Science, Intervention and Technology,3 Division of Baxter Novum and Renal Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden

Correspondence to: A. Olszowska, Department of Nephrology, Military Institute of Medicine, Szaserow Str 128, 00-909 Warsaw, Poland. aolszowska{at}interia.pl

{diamondsuit} Objective: To evaluate peritoneal transport of fluid and solutes in continuous ambulatory peritoneal dialysis (CAPD) patients using amino acid (AA)-based versus glucose-based dialysis solutions.

{diamondsuit} Methods: Using iodine-labeled human serum albumin (125I-HSA) as intraperitoneal volume marker, peritoneal transport was investigated in a group of 20 clinically stable patients (11 females and 9 men, age 53 ± 15 years) on CAPD for 15 – 101 months. Two paired 4-hour dwells, one with 1.36% glucose and one with 1.1% AA dialysis solution, were performed in each patient. Intraperitoneal dialysate volume, fluid absorption rate, and diffusive mass transport coefficients (KBD) and sieving coefficients (S) for glucose, creatinine, urea, potassium, and total protein were estimated for each dwell study. Dwell studies with AA solution were used to estimate KBD values for individual AAs.

{diamondsuit} Results: Intraperitoneal dialysate volume was higher for AA solution in comparison with glucose solution due to the higher osmolality of the AA solution. No statistically significant difference was found for KBD or S for creatinine, urea, potassium, or total protein in the dwell studies with either solution, whereas KBD for glucose was higher with AA than with glucose solution. Mean values of KBD of AA were similar but with high standard deviation, reflecting inter-individual variations in peritoneal transport rate.

{diamondsuit} Conclusion: Our results indicate that the AA peritoneal transport rate is strongly dependent on transport characteristics of the individual peritoneal membrane.

KEY WORDS: Amino acid solution; fluid transport; solute transport; diffusive mass transport coefficient.

Received 24 July 2006; accepted 18 May 2007.






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