No increase in small-solute transport in peritoneal dialysis patients treated without hypertonic glucose for fifty-four months

BMC Nephrology

Research Article

Celia Lessore de Sainte Foy¹  Dominique Pagniez¹  Alain Duhamel²  Jean-Baptiste Beuscart²  Eric Boulanger³ 

[1] CHU Lille, Nephrology Department, F-59000, Lille, France;Univ. Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000, Lille, France;Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, F-59000, Lille, France;

关键词: Glucose exposure;    Glucose sparing;    Small-solute transport;    Peritoneal dialysis;    Peritoneal equilibration test;   

DOI  :  10.1186/s12882-017-0690-7

 received in 2016-03-09, accepted in 2017-08-17,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundGlucose is widely used as an osmotic agent in peritoneal dialysis (PD), but exerts untoward effects on the peritoneum. The potential protective effect of a reduced exposure to hypertonic glucose has never been investigated.MethodsThe cohort of PD patients attending our center which tackled the challenge of a restricted use of hypertonic glucose solutions has been prospectively followed since 1992. Small-solute transport was assessed using an equivalent of the glucose peritoneal equilibration test after 6 months, and then every year. Study was stopped on July 1st, 2008, before use of biocompatible solutions. Repeated measures in patients treated with PD for 54 months were analyzed by using (1) the slopes of the linear regression for D4/D0 ratios over time computed for each individual, and (2) a linear mixed model.ResultsIn the study period, 44 patients were treated for a total of 2376 months, 2058 without hypertonic glucose. There was one episode of peritoneal infection every 18 patient-months. The mean of slopes of the linear regression for D4/D0 ratios was found to be significantly positive (Student’s test, p < .001) and the results of the mixed model reflected a similar significant increase for D4/D0 ratios over time. These results reflected a significant decrease of small-solute transport.ConclusionIn this large series, minimizing the use of hypertonic glucose solutions was associated in patients on long term PD with an overall decrease of small-solute transport within 54 months, despite a high rate of peritoneal infection.

【 授权许可】

CC BY   
© The Author(s). 2017