The effect of colchicine on the peritoneal membrane

Peritoneal dialysis (PD) is a treatment modality for patients with renal failure. Peritoneal fibrosis is one of the most serious complications after long-term continuous ambulatory peritoneal dialysis (CAPD). Histological studies in both humans and animals show that chronic peritoneal dialysis results in fibrosis of the peritoneal membrane. In our study, we investigated the effect of colchicine on peritoneal alterations induced by hypertonic PD solution in rats. Sprague-Dawley rats intraperitoneally received saline (control group) once daily, for 28 days, or 3.86% glucose (PDF group), or 3.86% glucose plus colchicine (colchicine group). Animals from each group were sacrificed after 28 days with anesthetized ketamine (60 mg/kg BW). For the PD fluid assessment, 1 h before the sacrifice of animals, 10 mL PD fluid of 2.27% glucose was given, and this fluid was obtained after the sacrifice. The levels of transforming endothelial growth factor beta (TGF-beta), tumor necrosis factor alpha (TNF-alpha) and albumin were investigated both in the peritoneal dialysate and blood, and the levels of malondialdehyde (MDA) were investigated only in peritoneal dialysate. The peritoneal membrane was evaluated histologically by light microscopy. When groups were compared in terms of body weight change, the colchicine group significantly lost weight compared to controls and PDF group (-4.7% + 4.5, 3.5% +/- 7.2, 3.0% +/- 1.3, respectively, p = 0.018). Also, the blood albumin level was significantly lower for these in the colchicine group compared to those in the PDF group (2.7 +/- 0.35 versus 3.2 +/- 0.3 g/dL, respectively, p = 0.048). The blood TGF-beta level was significantly lower in the control group, and no difference was observed between the PDF and colchicine groups (294.4 +/- 67.5 versus 787.4 +/- 237.4 versus 615.3 +/- 235.1 pg/mL, respectively, p = 0.004). The mesothelial thickness found in groups was as follows: control group 102 +/- 18.9 microm, PDF group 128.33 +/- 33.1 microm, colchicine group 117 +/- 35.6 microm (p = 0.34). In conclusion, a rat model for peritoneal dialysis associated peritoneal derangement without fibrosis could be induced. Colchicine could not prevent peritoneal derangement in this model.     

Effects of atorvastatin on development of peritoneal fibrosis in rats on peritoneal dialysis

Rational: Peritoneal sclerosis is one of the important complications of long-term peritoneal dialysis (PD). In this study, efficacy of atorvastatin on peritoneal histology and functions in non-uremic rats on PD was tested. Objectives: Twenty-two non-uremic Wistar albino rats were randomized into three groups: Sham (intraperitoneal saline), peritoneal dialysis (PD, intraperitoneal 3.86% dextrose containing PD solution), and treatment (TX, intraperitoneal 3.86% dextrose containing PD solution plus atorvastatin added into drinking water). At the end of a 4-week period, 1 h peritoneal equilibration test was performed. Serum lipids and certain cytokines, mediators, markers, and antioxidant enzyme activities in serum and dialysate were studied. Peritoneal thickness was measured and peritoneal inflammation, fibrosis, and vascular proliferation were scored in histological sections. Main findings: In histological examinations, inflammation, fibrosis, and vascular proliferation were significantly more frequent in PD group than Sham group and it seemed to decrease significantly when atorvastatin was used in conjunction with PD. Additionally, peritoneum was significantly thicker in PD group when compared to that of Sham and TX groups. Serum parameters did not significantly differ between groups. On the other hand, dialysate glutathione reductase (GR) activity and TGF-β were significantly lower in TX group than that of the PD group, whereas dialysate IL-6 level was higher in TX group. Principal conclusions: In our study, atorvastatin use appeared to diminish structural changes in peritoneum. Decreased expression of TGF-β in dialysate may be one of the possible underlying mechanisms.     

High mobility group box 1 and tumor growth factor β: useful biomarkers in pediatric patients receiving peritoneal dialysis

Background: Peritonitis, the most important limitation of peritoneal dialysis (PD), could be detected by biomarkers in dialysate effluent, representing a noninvasive method to indirectly assess the peritoneum status. The aim of our study was to test high mobility group box 1 (HMGB1) in PD patients, evaluating its role as precocious marker of peritoneum damage during peritonitis. Transforming growth factor (TGF)-β was correlated with peritoneal transport characteristics.

Methods: Six patients, treated by ambulatory PD, were enrolled. Samples were collected at the onset of peritonitis (T1) and every day until its resolution (T-end). Serum (s) and peritoneal (p) white blood cell (WBC) count was also evaluated. Peritoneal Equilibration Test evaluated the filter activity of peritoneum.

Results: In patients with acute peritonitis, the highest serum and peritoneal HMGB1 values (64?±?3.6 and 70?±?5.3?ng/mL, respectively) were assessed, with a progressive decrease of their levels at the resolution time (T-end: sHMGB1:36?±?2.5; pHMGB1:30.5?±?7.0?ng/mL). While no differences of sWBC and pWBC were observed between baseline and T-end values, pHMGB1 levels remained higher at T-end than those observed at T0 (pHMGB1:30.5?±?7.0 versus 6.9?±?3.6; p?p?=?0.01). An inverse correlation was found between TGF-β levels and dialysate/plasmatic creatinine values (r = ?0.83; p?=?0.03).

Conclusion: HMGB1 represents a useful biomarker for peritoneum evaluation in PD patients. A prognostic role of this alarmin, as a marker of response to therapy, could be hypothesized. TGF-β could predict the peritoneal transport status and dialysis technique adequacy.     

The effects of Panax notoginseng saponins on the cytokines and peritoneal function in rats with peritoneal fibrosis

Abstract

Background: Due to the long-term and chronic exposure to the peritoneal dialysis fluid, patients could develop peritoneal fibrosis and ultrafiltration failure which compromises treatment efficacy and outcome, and fibrosis is the major cause of peritoneal dialysis (PD) withdraw among patients. Methods: Twenty-one male WISTAR rats were randomly assigned to three groups, namely saline group, standard peritoneal dialysis fluid (PDF) group, and panax notoginseng saponins (PNS) group. Peritoneal fibrosis was induced by daily injection of PDF for 4 weeks. After execution, multiple histological techniques including HE and Masson's trichrome staining and transmission electron microscopy (TEM) were applied to observe the pathological changes and concentrations of multiple cytokines may involve in the process of fibrosis were determined by enzyme-linked immune sorbent assay (ELISA). Biochemistry parameters were determined by automated chemistry analyzer. Results: PNS can significantly inhibit the expression of transforming growth factor beta (TGF-β1), connective tissue growth factor (CTGF), and monocyte chemoattractant protein (MCP-1) in the peritoneum of rats. Furthermore, pathological damages, including extracellular matrix deposition, vascularization, and fibroblast, were ameliorated in PNS group when being compared with standard PDF group. Peritoneal functions were improved by regular PNS treatment with significantly elevated ultrafiltration. Conclusion: PNS is capable of improving peritoneal function in subjects with PDF exposure and can possibly applied in patients with PD after further verification.     

Risk factors of severe peritoneal sclerosis in chronic peritoneal dialysis patients

Peritoneal dialysis (PD) offers the healthiest way for starting renal replacement therapy (RRT) in End Stage Renal Disease patients, however exposes long-term PD patients to a dangerous complication named encapsulating peritoneal sclerosis (EPS). In this study, we searched for possible risk factors of EPS. Data were collected from two PD centers covering period 1995–2012 and comprised 464 patients. Control group defined as PD patients stayed on PD >42 month (n?=?122), and case group was 12 confirmed EPS patients. Associations were analyzed using linear regression analysis. Prevalence and incidence of EPS were 2.59% and 8.9% with an incidence of 0.7% patient-years, respectively. The age at start of PD in EPS patients (32.75?±?10.8 year) was significantly lower compared with control group (49.61?±?16.18 year, p?=?.0001). The mean duration of PD in EPS and control group were 2494.4?±?940.9 and 1890.2?±?598.8 days (p?=?.002). Control group had 145 episodes of peritonitis during total duration of 7686 patient months (peritonitis rate of 1/53). This was 1/26 with a total 38 episodes of peritonitis during the total duration of 997 patient months (p?=?.01) for EPS group. In regression analysis, PD duration, age at PD start and duration of Ultrafiltration failure (UFF) were associated with EPS. Longer time being on PD, younger age, and higher UFF duration were the risk factors for EPS development.     

Association of dialysate calcium concentration with fetuin a level and carotid intima-media thickness in peritoneal dialysis patients

Serum fetuin A has been shown to be associated with the risk of vascular calcification and atherosclerosis, and it can predict the onset of cardiovascular mortality in dialysis patients. The carotid intima-media thickness (cIMT) is an accessible and reliable method to identify the subclinical atherosclerosis. The aim of this study was to investigate the relationships between dialysate calcium concentrations and fetuin A or cIMT in patients undergoing peritoneal dialysis (PD). Forty patients, newly diagnosed end-stage renal disease (ESRD) and undergoing peritoneal dialysis, were enrolled in the study, with a calcium content of the peritoneal dialysis (PD) solution of 1.25?mmol/L in 20 patients (low-Ca group) and 1.75?mmol/L in 20 patients (standard-Ca group). The patients were followed up for 12 months after the PD conducted. Serum fetuin A was determined using a human fetuin A enzyme-linked immunosorbent assay kit and cIMT was detected using ultrasonic wave. We observed no difference between two groups with regard to the baseline data of fetuin A, cIMT, calcium, phosphorus, calcium-phosphorus product, high sensitivity CRP (hsCRP), parathyroid hormone (PTH), or lipid parameters. After 12 months follow-up, fetuin A (263.92?±?16.1 vs. 282.76?±?21.0, p?=?0.017) and calcium-phosphorus product (39.85?±?7.76 vs. 47.50?±?6.65, p?=?0.009) were obviously lower in the low-Ca group than standard-Ca group, the other serum parameters were not different between these two groups. Compared with baseline data, serum fetuin A concentration significantly reduced in low-Ca group (?p?p?相似文献   

The influence of low calcium dialysate on left ventricular diastolic function in peritoneal dialysis patients

Left ventricular (LV) diastolic function was found to be a significant predictor of cardiovascular events and general mortality in dialysis. Studies have indicated that dialysate calcium concentrations were significantly associated with cardiac function. However, the relationship between low calcium dialysate and LV diastolic function has not been clear. The aim of this study was to investigate the influence of low calcium dialysate on cardiac function in peritoneal dialysis (PD) patients. A total of 60 PD patients were enrolled in this study, with a calcium content of the PD solution of 1.25?mmol/L in 30 patients (low-calcium group) and 1.75?mmol/L in 30 patients (standard-calcium group). Standard M-mode and two-dimensional ultrasound measurements were applied to detect the cardiac function. After 12-month follow-up, we found no significant difference in blood pressure, calcium, phosphorus, parathyroid hormone (PTH), etc., between the two groups. Residual renal function (RRF), which is associated with LV cardiac function, was significantly decreased in the standard-calcium group compared with the low-calcium group (5.64?±?3.23 vs. 9.38?±?3.17, p?=?.001). Compared with the low-calcium group, E_max (peak early diastolic velocity) and A_max (peak late diastolic velocity) were significantly decreased (p?p?相似文献   

Presence of galectin-3 in peritoneal dialysate. Does it have a role in the peritoneal membrane inflammatory process?

Peritoneal dialysis (PD) causes structural and functional changes in the peritoneal membrane, which are attributed to local inflammatory process. This study assessed the presence of galectin-3 (Gal-3), a known inflammatory modulator, in dialysate effluent and correlated its levels with markers of inflammatory process. Gal-3 levels in serum and dialysate effluent were measured in prevalent PD patients on morning visits (n = 27) or during peritoneal equilibration tests (PET, n = 16), it association with clinical and laboratory parameters, including dialysate/plasma creatinine (D/P creatinine) and interleukin-6 (IL-6) levels was analysed. Gal-3 levels in dialysate effluent correlated with D/P creatinine (0.663, p = 0.005) and dialysate effluent IL-6 levels (0.674, p = 0.002), but not with serum Gal-3 levels or dialysis vintage. Patients who were high transporters had higher Gal-3 levels in dialysate effluent, as compared to lower transporters. In multivariate regression analysis, dialysate IL-6 level was the strongest predictor of dialysate Gal-3 levels. This study found Gal-3 in dialysate effluent correlated with D/P creatinine and dialysate IL-6 levels. These findings may imply that Gal-3 has a role in the intraperitoneal inflammatory process. However, this needs to be investigated further.     

Icodextrin Dialysate Improves Nutritional and Inflammatory Profiles in Peritoneal Dialysis Patients

Background. Previous studies demonstrate that icodextrin is superior to 4.25%?dextrose for fluid removal in patients with high and high-average transport membrane. Recent studies reveal that controlling volume status improves malnutrition in peritoneal dialysis (PD) patients. This study hypothesized that icodextrin enhances nutritional and inflammatory status by improving fluid balance. Methods. This retrospective case-control study investigated the effects of icodextrin on patient nutritional profiles over a one-year period. Thirty-two patients who used icodextrin for more than one year were classified as the “icodextrin group.” Ten patients who used glucose-containing dialysate without icodextrin were classified as the control group. Clinical and laboratory parameters were compared between groups. Demographic and laboratory parameters were analyzed at baseline, 3 months, 6 months, and 12 months after starting icodextrin dialysis. Results. Ultrafiltration of icodextrin per exchange in the icodextrin group was 66%?higher than that for 4.25%?dextrose exchange in the icodextrin group (icodextrin vs. 4.25%?dextrose: 492.1?±?204.5 vs. 296.1?±?115.3 mL/exchange; p?<?0.0001, paired t-test). The increased albumin and normalized protein catabolic rate (nPCR) after icodextrin for one year was unique for the icodextrin group (p?<?0.0001 and p?<?0.0001, respectively). The inflammatory marker high sensitivity C-reactive protein (hsCRP) decreased significantly only in the icodextrin group (p?=?0.0048). Conclusion. Icodextrin dialysate may improve nutritional and inflammatory status in PD patients. However, the long-term clinical effects of icodextrin require further study.     

Peritoneal dialysis fluid-induced changes of the peritoneal membrane are reversible after peritoneal rest in rats.

BACKGROUND: Peritoneal dialysis (PD) is associated with functional and structural alterations of the peritoneal membrane. However, the (ir)reversibility of these pathological changes of the peritoneum is not understood fully. METHODS: In an experimental PD model, rats (n = 15) received daily 10 ml conventional glucose containing PD fluid, via peritoneal catheters connected to implanted subcutaneous mini vascular access ports. After 5 weeks of treatment, the first group of animals (PDF; n = 10) was sacrificed, while peritoneal catheters of the remaining group of rats (PD-rest; n = 5) were removed 1 week later. The latter group (PD-rest) was sacrificed 12 weeks after removing catheters. At both time points, untreated rats were included as controls. Cellular and morphological parameters were analysed by light and electron microscopy. RESULTS: Rats exposed to PD fluid for 5 weeks showed a severe angiogenesis in various peritoneal tissues. Peritoneal rest resulted in a significant reduction in blood vessel density in visceral (mesentery, P<0.05), but not in parietal peritoneum. Five weeks' exposure to PD fluid resulted in a profound fibrosis in the parietal peritoneum, whereas the degree of fibrosis was significantly reduced in the PD-rest group (P<0.02). Daily exposure to PD fluid induced a higher number of mast cells in the omentum compared with untreated rats, whereas peritoneal rest normalized the increased mast cell density completely (P<0.03). Likewise, continued PD fluid instillation evoked a strong omental milky spot response, which was returned to the control level after peritoneal rest (P<0.009). Furthermore, the number of mesothelial cells on the liver was significantly increased in rats treated with PD fluid, whereas animals from the PD-rest group had a lower number of mesothelial cells, although this was not statistically significant (P = 0.08). Finally, as evidenced by electron microscopy, daily exposure to PD fluid resulted in severe damage to the mesothelial cell layer covering the peritoneum, whereas this cell layer was completely recovered after peritoneal rest. CONCLUSIONS: We show that PD fluid-induced cellular and morphological alterations of the peritoneal membrane are generally reversible.     

Risk factor(s) related to high membrane permeability in peritoneal dialysis

Aim: Peritoneal dialysis (PD) patients have different peritoneal membrane permeability (transport) characteristics. High peritoneal membrane permeability is associated with increased mortality risk in the patient population. In this study, we aimed to investigate possible risk factor(s) related to high peritoneal membrane permeability. Patients and method: The study included 475 PD patients (46.1?±?14.5 years of mean age; 198 female and 277 male). The patients were divided two groups according to peritoneal equilibration test (PET) result: high-permeability group (high and high-average) and low- permeability group (low-average and low). Results: In both the univariate and multivariate logistic regression analyses, it was found that diabetes mellitus and hypoalbuminemia was significantly associated with high peritoneal membrane permeability [relative risk (RR): 1.90, 95% confidence interval (CI): 1.26–2.86, p: 0.002 and RR: 2.14, 95% CI: 1.44–3.18, p<0.001, respectively]. Conclusion: Diabetes mellitus and hypoalbuminemia were closely associated with high peritoneal membrane permeability. Diabetic patients had 1.9 times the likelihood of having high permeability. However, the relationship between hypoalbuminemia and high peritoneal permeability appears to be a result rather than cause.     

Levels of transforming growth factor β1 during first six months of peritoneal dialysis

Abstract

Transforming-growth factor β1 (TGF-β1) is a powerful cytokine involved in physiological processes of growth, differentiation, gene expression, embryogenesis, tissue remodelling, wound healing as well as tumorigenesis, immunosuppression and fibrosis, like peritoneal membrane fibrosis on long-term peritoneal dialysis (PD) treatment. The aims of this study were to determine TGF-β1 levels in serum (s) and drained dialysate (dd), to assess their relations to sex, age, diabetes, dialysis modality, peritonitis and use of erythropoiesis stimulating agents (ESAs), inhibitors of angiotensin-converting enzyme (ACEi) and/or statins in 20 patients, 11 men and 9 women, mean age 62.90?±?12.69 years, free of peritonitis during the first 6 months of PD treatment. There was no statistically significant difference in TGF-β1 concentrations in serum and drained dialysate at the beginning and after first 6 months of chronic PD, in patients of different sex, age and diabetic patients versus non-diabetic. The significant positive correlations between sTGF-β1 levels and glycemia at the beginning and cholesterolemia after 6 months of PD treatment suggest higher TGF-β1 concentrations in patients with unfavorable metabolic profile. Expression of TGF-β1 in effluent dialysate was significantly lower in patients on chronic PD using ACEi therapy, suggesting ACEi to have a protective effect on peritoneal membrane. Patients on ESA had slightly lower sTGF-β1 concentrations after the first 6 months of PD treatment.     

Body composition measurements using bioimpedance analysis in peritoneal dialysis patients are affected by the presence of dialysate

The presence of peritoneal dialysate when performing bioimpedance analysis may affect body composition measurements. The aim of this study was to evaluate the impact of dialysate on body composition measurements in Asians. Forty‐one patients undergoing maintenance peritoneal dialysis in our hospital peritoneal dialysis unit were included in this study. Dialysate was drained from the abdomen prior to measurement, and bioimpedance analysis was performed using multi‐frequency bioimpedance analysis, with each subject in a standing position (D‐). Dialysate was then administered and the measurement was repeated (D+). The presence of peritoneal dialysate led to an increase in intracellular water (ICW), extracellular water (ECW), and total body water (D‐: 20.33 ± 3.72 L for ICW and 13.53 ± 2.54 L for ECW; D+: 20.96 ± 3.78 L for ICW and 14.10 ± 2.59 L for ECW; P < 0.001 for both variables). Total and trunk oedema indices were higher in the presence of peritoneal dialysate. In addition, the presence of peritoneal dialysate led to an overestimation of mineral content and free fat mass (FFM) for the total body; but led to an underestimation of body fat (D‐: 45.80 ± 8.26 kg for FFM and 19.30 ± 6.27 kg for body fat; D+: 47.51 ± 8.38 kg for FFM and 17.59 ± 6.47 kg for body fat; P < 0.001 for both variables). Our results demonstrate that the presence of peritoneal dialysate leads to an overestimation of FFM and an underestimation of fat mass. An empty abdomen is recommended when evaluating body composition using bioimpedance analysis.     

Dialysate CA125 levels after 5 years on continuous peritoneal dialysis

The aim of this study was to evaluate longitudinal changes in dialysate cancer antigen 125 (dCA125) levels over time and to analyze relationships between dCA125 and peritoneal glucose exposure (PGE) in children undergoing long-term peritoneal dialysis (PD). The study group included seven boys and four girls (mean age 13 ± 5.1 years) with a mean PD duration of 84.0 ± 1.1 months. A peritoneal equilibration test (PET) was performed, and dCA125 levels were measured in all patients. Peritoneal appearance rates (AR) of dCA125, the velocity of the decrease in dCA125AR values, and annual PGE levels were also calculated. The final tests were performed at a mean of 63.3 ± 3.5 months after the initial ones. Both dCA125 and dCA125AR levels showed statistically significant decrements during the follow-up period (p = 0.003), with the velocity of decrease in dCA125AR found to be 52.6 ± 19.4%. There were no significant differences in peritoneal transport parameters between the beginning and end of the study period. PGE values were significantly higher in the last year of the study than in the first year (p = 0.014), but the velocity of the decrease in dCA125AR levels was not related to total PGE. In conclusion, a significant decline was found in dCA125 and CA125 AR levels, reflecting mesothelial cell mass, in children undergoing long-term PD (>5 years), but these were not related to PGE.     

Beneficial effects of aminoguanidine on peritoneal microcirculation and tissue remodelling in a rat model of PD.

BACKGROUND: The formation of glucose degradation products (GDPs) and accumulation of advanced glycation end products (AGEs) partly contribute to the bioincompatibility of peritoneal dialysis fluids (PDF). Aminoguanidine (AG) scavenges GDPs and prevents the formation of AGEs. METHODS: In a peritoneal dialysis (PD) rat model, we evaluated the effects of the addition of AG to the PDF on microcirculation and morphology of the peritoneum, by intravital microscopy and quantitative morphometric analysis. RESULTS: AG-bicarbonate effectively scavenged different GDPs from PDF. Daily exposure to PDF for 5 weeks resulted in a significant increase in leucocyte rolling in mesenteric venules, which could be reduced for approximately 50% by addition of AG-bicarbonate (P<0.02). Vascular leakage was found in rats treated with PDF/AG-bicarbonate, but not with PDF alone. Evaluation of visceral and parietal peritoneum showed the induction of angiogenesis and fibrosis after PDF instillation. PDF/AG-bicarbonate significantly reduced vessel density in omentum and parietal peritoneum (P<0.04), but not in mesentery. PDF-induced fibrosis was significantly reduced by AG (P<0.02). PDF instillation led to AGE accumulation in mesentery, which was inhibited by supplementation of AG. Since addition of AG-bicarbonate to PDF raised pH from 5.2 to 8.5, a similar experiment was performed with AG-hydrochloride that did not change the fluid acidity. We could reproduce most of the results obtained with AG-bicarbonate; however, AG-hydrochloride induced no microvascular leakage and had a minor effect on angiogenesis. CONCLUSION: The supplementation of either AG reduced a number of PDF-induced alterations in our model, emphasizing the involvement of GDPs and/or AGEs in the PDF-induced peritoneal injury.     

Comparison of peritoneal equilibration test with 2.27% and 3.86% glucose dialysis solution

BACKGROUND: The standard Peritoneal Equilibration Test (PET) uses a 2.27% glucose dialysis solution in peritoneal dialysis (PD). A more hypertonic solution (3.86%) has recently been proposed to obtain further information about ultrafiltration (UF). AIM: To compare results in terms of peritoneal solute transport (4h-dialysate-to-plasma ratio, 4h-D/P) between 2.27% and 3.86% PET. DESIGN: 23 patients on PD were randomized to form two groups, A and B. A 2.27% dextrose 2-L exchange was used in group A, followed on the same day by a 3.86% dextrose 2-L exchange, both with a 4-hour dwell (2.27% and 3.86% PET); in group B, the same treatment was administered in reverse. 4h-D/P of urea, creatinine and sodium at time 0, 60, 120 and 240 minutes and net UF were calculated for each PET and compared. RESULTS: No significant statistical differences were found for the usual peritoneal transport indexes, 4h-D/P of urea and creatinine, between 2.27% and 3.86% PET, which produced almost identical results. The creatinine 4h-D/P were 0.67+/-0.09 vs. 0.66+/-0.10 (p= NS) and the urea 4h-D/P 0.91+/-0.04 vs. 0.90+/-0.04 (p= NS). The sodium D/P was lower at all times during the 3.86% PET: D/P60= 0.92+/-0.05 vs. 0.88+/-0.03, D/P120= 0.91+/-0.02 vs. 0.87+/-0.03, D/P240= 0.92+/-0.02 vs. 0.88+/-0.04 (p< 0.0001). The net UF was 478 +/- 175 vs. 936 +/- 233 mL respectively (p< 0.0001). CONCLUSION: Our study suggests that a 3.86% PD solution could be used for PET instead of the 2.27% solution in order to assess peritoneal solute transport, as well as UF, while obtaining almost identical results as the 2.27% solution.     

Clinical Outcome Following the Use of Inadequate Solutions for Continuous Veno-Venous Hemodiofiltration

Backgrounds. A short time ago, commercially available diafiltration and replacement fluids could be found o n the hospital in Turkey. Instead, peritoneal dialysis solution (PDS) for continue veno-venous hemodiafiltration (CVVHDF) therapy and normal saline as replacement fluid are used. In this retrospective study, we investigated the effects of PDS and bicarbonate-buffered hemofiltration solution (Bic-HFS). Methods. We did a retrospective chart review of 24 patients treated with continue renal replacement therapy (CRRT) between January 2004 and February 2008. Peritoneal dialysis solution (PDS) was used in 14 patients, and bicarbonate-buffered hemodialysis solution (bic-HFS) was used in 10 patients. Results. Demographic data, laboratory findings, and mortality rate were similar both groups. Blood glucose and lactate levels were higher in the PD group than the bic-HFS group (p < 0.05). Hyperglycemia occurred more frequent in the PDS group than in the bic-HFS group (64% versus 30%, respectively; p < 0.05). Metabolic acidosis occurred in eight patients (57%) in the PDS group and three patients (30%) in the bic-HFS group (p < 0.05). Hypotension was higher in the PDS group (10, 71%) than in the bic-HFS group (3, 30%; p < 0.05). Conclusion. Using PDS fluid as dialysate for CVVHDF therapy is not a preferable solution because of the metabolic disturbances that it can cause.