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

BACKGROUND: Glucose 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. METHODS: The cohort of PD patients attending our center which ta...

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Autores principales: Pagniez, Dominique, Duhamel, Alain, Boulanger, Eric, Lessore de Sainte Foy, Celia, Beuscart, Jean-Baptiste
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5580320/
https://www.ncbi.nlm.nih.gov/pubmed/28859606
http://dx.doi.org/10.1186/s12882-017-0690-7
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author Pagniez, Dominique
Duhamel, Alain
Boulanger, Eric
Lessore de Sainte Foy, Celia
Beuscart, Jean-Baptiste
author_facet Pagniez, Dominique
Duhamel, Alain
Boulanger, Eric
Lessore de Sainte Foy, Celia
Beuscart, Jean-Baptiste
author_sort Pagniez, Dominique
collection PubMed
description BACKGROUND: Glucose 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. METHODS: The 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 D(4)/D(0) ratios over time computed for each individual, and (2) a linear mixed model. RESULTS: In 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 D(4)/D(0) 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 D(4)/D(0) ratios over time. These results reflected a significant decrease of small-solute transport. CONCLUSION: In 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12882-017-0690-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-55803202017-09-07 No increase in small-solute transport in peritoneal dialysis patients treated without hypertonic glucose for fifty-four months Pagniez, Dominique Duhamel, Alain Boulanger, Eric Lessore de Sainte Foy, Celia Beuscart, Jean-Baptiste BMC Nephrol Research Article BACKGROUND: Glucose 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. METHODS: The 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 D(4)/D(0) ratios over time computed for each individual, and (2) a linear mixed model. RESULTS: In 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 D(4)/D(0) 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 D(4)/D(0) ratios over time. These results reflected a significant decrease of small-solute transport. CONCLUSION: In 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12882-017-0690-7) contains supplementary material, which is available to authorized users. BioMed Central 2017-08-31 /pmc/articles/PMC5580320/ /pubmed/28859606 http://dx.doi.org/10.1186/s12882-017-0690-7 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Pagniez, Dominique
Duhamel, Alain
Boulanger, Eric
Lessore de Sainte Foy, Celia
Beuscart, Jean-Baptiste
No increase in small-solute transport in peritoneal dialysis patients treated without hypertonic glucose for fifty-four months
title No increase in small-solute transport in peritoneal dialysis patients treated without hypertonic glucose for fifty-four months
title_full No increase in small-solute transport in peritoneal dialysis patients treated without hypertonic glucose for fifty-four months
title_fullStr No increase in small-solute transport in peritoneal dialysis patients treated without hypertonic glucose for fifty-four months
title_full_unstemmed No increase in small-solute transport in peritoneal dialysis patients treated without hypertonic glucose for fifty-four months
title_short No increase in small-solute transport in peritoneal dialysis patients treated without hypertonic glucose for fifty-four months
title_sort no increase in small-solute transport in peritoneal dialysis patients treated without hypertonic glucose for fifty-four months
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5580320/
https://www.ncbi.nlm.nih.gov/pubmed/28859606
http://dx.doi.org/10.1186/s12882-017-0690-7
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