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The clinical usefulness of peritoneal dialysis fluids with neutral pH and low glucose degradation product concentration: an open randomized prospective trial

 Hoon Young Choi  ;  Dong Ki Kim  ;  Tae Hee Lee  ;  Sung Jin Moon  ;  Seung Hyeok Han  ;  Jung Eun Lee  ;  Beom Seok Kim  ;  Hyeong Cheon Park  ;  Kyu Hun Choi  ;  Sung Kyu Ha  ;  Dae-Suk Han  ;  Ho Yung Lee 
 Peritoneal Dialysis International, Vol.28(2) : 174-182, 2008 
Journal Title
 Peritoneal Dialysis International 
Issue Date
BACKGROUND: Long-term peritoneal dialysis (PD) is associated with the development of various structural and functional changes to the peritoneal membrane when bioincompatible conventional peritoneal dialysis fluids (PDFs) are used. In this study, we looked at patients that were treated with conventional PDFs and then changed to novel biocompatible PDFs with a neutral pH and a low concentration of glucose degradation products (GDPs) to investigate whether this change could result in the arrest or reversal of peritoneal membrane deterioration. METHODS: In an open label, randomized prospective trial, the clinical effects of conventional PDFs and biocompatible PDFs with neutral pH and very low concentration of GDPs were compared in 104 patients equally divided between both study PDFs. Blood and effluent dialysate samples, peritoneal equilibration tests, and adequacy evaluation were undertaken at baseline, 4, 8, and 12 months. The target variables were the ratio of dialysate-to-plasma (D/P) creatinine, peritoneal ultrafiltration, residual renal function, dialysis adequacy indices, and effluent cancer antigen 125 (CA125). RESULTS: D/P creatinine values were not different in the two groups. Peritoneal ultrafiltration was significantly higher in the low-GDP PDF group than in the conventional PDF group at all follow-up times (4 months: 9.1 +/- 4.3 vs 6.0 +/- 3.0; 8 months: 8.3 +/- 3.4 vs 6.0 +/- 3.0; 12 months: 8.9 +/- 3.3 vs 6.1 +/- 3.3 mL/g dextrose/day; p < 0.05). Peritoneal Kt/V urea values and total weekly Kt/V urea values at 4 months were significantly higher in the low-GDP PDF group than in the conventional PDF group. Residual renal function was not statistically significant. Effluent CA125 levels were significantly higher in the low-GDP PDF group at all follow-up visits (4 months: 37.8 +/- 20.8 vs 22.0 +/- 9.5; 8 months: 41.2 +/- 20.3 vs 25.9 +/- 11.3; 12 months: 40.4 +/- 21.4 vs 28.6 +/- 13.0 U/mL; p < 0.05). Among anuric patients, peritoneal ultrafiltration at 4, 8, and 12 months, total weekly Kt/V at 4 and 8 months, and CA125 levels at all follow-up visits were significantly higher in patients treated with low-GDP PDF than those treated with conventional PDF. However, among anuric patients, D/P creatinine showed no significant differences between the low-GDP PDF group and the conventional PDF group. CONCLUSION: The use of biocompatible PDFs with neutral pH and low GDP concentration can contribute to improvement of peritoneal ultrafiltration and peritoneal effluent CA125 level, an indicator of peritoneal membrane integrity in PD patients
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김동기(Kim, Dong Ki)
김범석(Kim, Beom Seok) ORCID logo https://orcid.org/0000-0002-5732-2583
문성진(Moon, Sung Jin)
박형천(Park, Hyeong Cheon) ORCID logo https://orcid.org/0000-0002-1550-0812
이정은(Lee, Jung Eun) ORCID logo https://orcid.org/0000-0003-0917-2872
이태희(Lee, Tae Hee)
이호영(Lee, Ho Yung)
최규헌(Choi, Kyu Hun) ORCID logo https://orcid.org/0000-0003-0095-9011
최훈영(Choi, Hoon Young) ORCID logo https://orcid.org/0000-0002-4245-0339
하성규(Ha, Sung Kyu)
한대석(Han, Dae Suk)
한승혁(Han, Seung Hyeok) ORCID logo https://orcid.org/0000-0001-7923-5635
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