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Part 5: Peritoneal Solution |
Faculty of Medicine, Second Department of Internal Medicine, Oita University, Yufu, Japan
Correspondence to: Tadashi Tomo, Second Department of Internal Medicine,
Faculty of Medicine, Oita University, Yufu, Oita 879-5593
Japan.
tomo{at}med.oita-u.ac.jp
In Japan, two types of new peritoneal dialysis fluid (PDF) are ordinarily
used: two-chambered PDF, and icodextrin PDF. Two-chambered PDF has several
biocompatible characteristics, one being low glucose degradation products
(GDPs). Of the several GDPs in PDF, 3,4-dideoxyglucosone-3-ene (3,4-DGE) is
thought to be strongly associated with the cytotoxicity of standard PDF. Using
a PDF low in GDPs may reduce exposure of the peritoneum to 3,4-DGE, helping to
preserve peritoneal function in PD patients. Additionally, use of a PDF low in
GDPs may reduce plasma levels of advanced glycosylation end-products in PD
patients, a change that may help to preserve vascular function in PD
patients.
Peritoneal rest for 24 hours after exposure to a PDF with low GDPs improves
the activity of human peritoneal mesothelial cells. As compared with the use
of standard PDF, the use of low-GDP PDF in combination therapy (peritoneal
dialysis plus hemodialysis) may more effectively preserve peritoneal function.
The new PDF low in GDPs has biocompatible characteristics relative to
peritoneum and system that may help to preserve peritoneal function or reduce
complications such as atherosclerosis or dialysis-related amyloidosis in
dialysis patients.
KEY WORDS: Glucose degradation products; GDPs; 3,4-dideoxyglucosone-3-ene; 3,4-DGE; combination therapy; PD-HD combination therapy.
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