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The Effect of Neutral Peritoneal Dialysis Solution with Low Glucose-Degradation-Product on the Fluid Status and Body Composition – A Randomized Control Trial

BACKGROUND: Previous studies report conflicting results on the benefit of peritoneal dialysis (PD) patients treated with low glucose degradation product (GDP) solution. The effects of low GDP solution on body fluid status and arterial pulse wave velocity (PWV) have not been studied. METHODS: We rand...

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Autores principales: Szeto, Cheuk-Chun, Kwan, Bonnie C. H., Chow, Kai-Ming, Cheng, Phyllis M. S., Kwong, Vickie W. K., Choy, Agnes S. M., Law, Man-Ching, Leung, Chi-Bon, Li, Philip K. T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625015/
https://www.ncbi.nlm.nih.gov/pubmed/26510186
http://dx.doi.org/10.1371/journal.pone.0141425
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author Szeto, Cheuk-Chun
Kwan, Bonnie C. H.
Chow, Kai-Ming
Cheng, Phyllis M. S.
Kwong, Vickie W. K.
Choy, Agnes S. M.
Law, Man-Ching
Leung, Chi-Bon
Li, Philip K. T.
author_facet Szeto, Cheuk-Chun
Kwan, Bonnie C. H.
Chow, Kai-Ming
Cheng, Phyllis M. S.
Kwong, Vickie W. K.
Choy, Agnes S. M.
Law, Man-Ching
Leung, Chi-Bon
Li, Philip K. T.
author_sort Szeto, Cheuk-Chun
collection PubMed
description BACKGROUND: Previous studies report conflicting results on the benefit of peritoneal dialysis (PD) patients treated with low glucose degradation product (GDP) solution. The effects of low GDP solution on body fluid status and arterial pulse wave velocity (PWV) have not been studied. METHODS: We randomly assigned 68 incident PD patients to low GDP (Intervention Group) or conventional solutions (Control Group); 4 dropped off before they received the assigned treatment. Patients were followed for 52 weeks for changes in ultrafiltration, residual renal function, body fluid status and arterial PWV. RESULT: After 52 weeks, Intervention Group had higher overhydration (3.1 ± 2.6 vs 1.9 ± 2.2 L, p = 0.045) and extracellular water volume (17.7 ± 3.9 vs 15.8 ± 3.1 L, p = 0.034) than Control Group. There was no significant difference in PWV between groups. There was no significant difference in residual renal function between the Groups. Intervention Group had lower ultrafiltration volume than Control Group at 4 weeks (0.45 ± .0.61 vs 0.90 ± 0.79 L/day, p = 0.013), but the difference became insignificant at later time points. Intervention Group had lower serum CRP levels than Control Group (4.17 ± 0.77 vs 4.91 ± 0.95 mg/dL, p < 0.0001). CONCLUSION: Incident PD patients treated with low GDP solution have less severe systemic inflammation but trends of less ultrafiltration, and more fluid accumulation. However, the effects on ultrafiltration and fluid accumulation disappear with time. The long term effect of low GDP solution requires further study. TRIAL REGISTRATION: ClinicalTrials.gov NCT00966615
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spelling pubmed-46250152015-11-06 The Effect of Neutral Peritoneal Dialysis Solution with Low Glucose-Degradation-Product on the Fluid Status and Body Composition – A Randomized Control Trial Szeto, Cheuk-Chun Kwan, Bonnie C. H. Chow, Kai-Ming Cheng, Phyllis M. S. Kwong, Vickie W. K. Choy, Agnes S. M. Law, Man-Ching Leung, Chi-Bon Li, Philip K. T. PLoS One Research Article BACKGROUND: Previous studies report conflicting results on the benefit of peritoneal dialysis (PD) patients treated with low glucose degradation product (GDP) solution. The effects of low GDP solution on body fluid status and arterial pulse wave velocity (PWV) have not been studied. METHODS: We randomly assigned 68 incident PD patients to low GDP (Intervention Group) or conventional solutions (Control Group); 4 dropped off before they received the assigned treatment. Patients were followed for 52 weeks for changes in ultrafiltration, residual renal function, body fluid status and arterial PWV. RESULT: After 52 weeks, Intervention Group had higher overhydration (3.1 ± 2.6 vs 1.9 ± 2.2 L, p = 0.045) and extracellular water volume (17.7 ± 3.9 vs 15.8 ± 3.1 L, p = 0.034) than Control Group. There was no significant difference in PWV between groups. There was no significant difference in residual renal function between the Groups. Intervention Group had lower ultrafiltration volume than Control Group at 4 weeks (0.45 ± .0.61 vs 0.90 ± 0.79 L/day, p = 0.013), but the difference became insignificant at later time points. Intervention Group had lower serum CRP levels than Control Group (4.17 ± 0.77 vs 4.91 ± 0.95 mg/dL, p < 0.0001). CONCLUSION: Incident PD patients treated with low GDP solution have less severe systemic inflammation but trends of less ultrafiltration, and more fluid accumulation. However, the effects on ultrafiltration and fluid accumulation disappear with time. The long term effect of low GDP solution requires further study. TRIAL REGISTRATION: ClinicalTrials.gov NCT00966615 Public Library of Science 2015-10-28 /pmc/articles/PMC4625015/ /pubmed/26510186 http://dx.doi.org/10.1371/journal.pone.0141425 Text en © 2015 Szeto et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Szeto, Cheuk-Chun
Kwan, Bonnie C. H.
Chow, Kai-Ming
Cheng, Phyllis M. S.
Kwong, Vickie W. K.
Choy, Agnes S. M.
Law, Man-Ching
Leung, Chi-Bon
Li, Philip K. T.
The Effect of Neutral Peritoneal Dialysis Solution with Low Glucose-Degradation-Product on the Fluid Status and Body Composition – A Randomized Control Trial
title The Effect of Neutral Peritoneal Dialysis Solution with Low Glucose-Degradation-Product on the Fluid Status and Body Composition – A Randomized Control Trial
title_full The Effect of Neutral Peritoneal Dialysis Solution with Low Glucose-Degradation-Product on the Fluid Status and Body Composition – A Randomized Control Trial
title_fullStr The Effect of Neutral Peritoneal Dialysis Solution with Low Glucose-Degradation-Product on the Fluid Status and Body Composition – A Randomized Control Trial
title_full_unstemmed The Effect of Neutral Peritoneal Dialysis Solution with Low Glucose-Degradation-Product on the Fluid Status and Body Composition – A Randomized Control Trial
title_short The Effect of Neutral Peritoneal Dialysis Solution with Low Glucose-Degradation-Product on the Fluid Status and Body Composition – A Randomized Control Trial
title_sort effect of neutral peritoneal dialysis solution with low glucose-degradation-product on the fluid status and body composition – a randomized control trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625015/
https://www.ncbi.nlm.nih.gov/pubmed/26510186
http://dx.doi.org/10.1371/journal.pone.0141425
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