Cargando…

A New Peritoneal Dialysis Solution Containing L-Carnitine and Xylitol for Patients on Continuous Ambulatory Peritoneal Dialysis: First Clinical Experience

Peritoneal dialysis (PD) is a feasible and effective renal replacement therapy (RRT) thanks to the dialytic properties of the peritoneal membrane (PM). Preservation of PM integrity and transport function is the key to the success of PD therapy, particularly in the long term, since the prolonged expo...

Descripción completa

Detalles Bibliográficos
Autores principales: Rago, Carmela, Lombardi, Teresa, Di Fulvio, Giorgia, Di Liberato, Lorenzo, Arduini, Arduino, Divino-Filho, José C., Bonomini, Mario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996173/
https://www.ncbi.nlm.nih.gov/pubmed/33668249
http://dx.doi.org/10.3390/toxins13030174
_version_ 1783670057110339584
author Rago, Carmela
Lombardi, Teresa
Di Fulvio, Giorgia
Di Liberato, Lorenzo
Arduini, Arduino
Divino-Filho, José C.
Bonomini, Mario
author_facet Rago, Carmela
Lombardi, Teresa
Di Fulvio, Giorgia
Di Liberato, Lorenzo
Arduini, Arduino
Divino-Filho, José C.
Bonomini, Mario
author_sort Rago, Carmela
collection PubMed
description Peritoneal dialysis (PD) is a feasible and effective renal replacement therapy (RRT) thanks to the dialytic properties of the peritoneal membrane (PM). Preservation of PM integrity and transport function is the key to the success of PD therapy, particularly in the long term, since the prolonged exposure to unphysiological hypertonic glucose-based PD solutions in current use is detrimental to the PM, with progressive loss of peritoneal ultrafiltration capacity causing technique failure. Moreover, absorbing too much glucose intraperitoneally from the dialysate may give rise to a number of systemic metabolic effects. Here we report the preliminary results of the first clinical experience based on the use in continuous ambulatory PD (CAPD) patients of novel PD solutions obtained through partly replacing the glucose load with other osmotically active metabolites, such as L-carnitine and xylitol. Ten CAPD patients were treated for four weeks with the new solutions. There was good tolerance to the experimental PD solutions, and no adverse safety signals were observed. Parameters of dialysis efficiency including creatinine clearance and urea Kt/V proved to be stable as well as fluid status, diuresis, and total peritoneal ultrafiltration. The promising tolerance and local/systemic advantages of using L-carnitine and xylitol in the PD solution merit further research.
format Online
Article
Text
id pubmed-7996173
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-79961732021-03-27 A New Peritoneal Dialysis Solution Containing L-Carnitine and Xylitol for Patients on Continuous Ambulatory Peritoneal Dialysis: First Clinical Experience Rago, Carmela Lombardi, Teresa Di Fulvio, Giorgia Di Liberato, Lorenzo Arduini, Arduino Divino-Filho, José C. Bonomini, Mario Toxins (Basel) Article Peritoneal dialysis (PD) is a feasible and effective renal replacement therapy (RRT) thanks to the dialytic properties of the peritoneal membrane (PM). Preservation of PM integrity and transport function is the key to the success of PD therapy, particularly in the long term, since the prolonged exposure to unphysiological hypertonic glucose-based PD solutions in current use is detrimental to the PM, with progressive loss of peritoneal ultrafiltration capacity causing technique failure. Moreover, absorbing too much glucose intraperitoneally from the dialysate may give rise to a number of systemic metabolic effects. Here we report the preliminary results of the first clinical experience based on the use in continuous ambulatory PD (CAPD) patients of novel PD solutions obtained through partly replacing the glucose load with other osmotically active metabolites, such as L-carnitine and xylitol. Ten CAPD patients were treated for four weeks with the new solutions. There was good tolerance to the experimental PD solutions, and no adverse safety signals were observed. Parameters of dialysis efficiency including creatinine clearance and urea Kt/V proved to be stable as well as fluid status, diuresis, and total peritoneal ultrafiltration. The promising tolerance and local/systemic advantages of using L-carnitine and xylitol in the PD solution merit further research. MDPI 2021-02-24 /pmc/articles/PMC7996173/ /pubmed/33668249 http://dx.doi.org/10.3390/toxins13030174 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Rago, Carmela
Lombardi, Teresa
Di Fulvio, Giorgia
Di Liberato, Lorenzo
Arduini, Arduino
Divino-Filho, José C.
Bonomini, Mario
A New Peritoneal Dialysis Solution Containing L-Carnitine and Xylitol for Patients on Continuous Ambulatory Peritoneal Dialysis: First Clinical Experience
title A New Peritoneal Dialysis Solution Containing L-Carnitine and Xylitol for Patients on Continuous Ambulatory Peritoneal Dialysis: First Clinical Experience
title_full A New Peritoneal Dialysis Solution Containing L-Carnitine and Xylitol for Patients on Continuous Ambulatory Peritoneal Dialysis: First Clinical Experience
title_fullStr A New Peritoneal Dialysis Solution Containing L-Carnitine and Xylitol for Patients on Continuous Ambulatory Peritoneal Dialysis: First Clinical Experience
title_full_unstemmed A New Peritoneal Dialysis Solution Containing L-Carnitine and Xylitol for Patients on Continuous Ambulatory Peritoneal Dialysis: First Clinical Experience
title_short A New Peritoneal Dialysis Solution Containing L-Carnitine and Xylitol for Patients on Continuous Ambulatory Peritoneal Dialysis: First Clinical Experience
title_sort new peritoneal dialysis solution containing l-carnitine and xylitol for patients on continuous ambulatory peritoneal dialysis: first clinical experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996173/
https://www.ncbi.nlm.nih.gov/pubmed/33668249
http://dx.doi.org/10.3390/toxins13030174
work_keys_str_mv AT ragocarmela anewperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience
AT lombarditeresa anewperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience
AT difulviogiorgia anewperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience
AT diliberatolorenzo anewperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience
AT arduiniarduino anewperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience
AT divinofilhojosec anewperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience
AT bonominimario anewperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience
AT ragocarmela newperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience
AT lombarditeresa newperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience
AT difulviogiorgia newperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience
AT diliberatolorenzo newperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience
AT arduiniarduino newperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience
AT divinofilhojosec newperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience
AT bonominimario newperitonealdialysissolutioncontaininglcarnitineandxylitolforpatientsoncontinuousambulatoryperitonealdialysisfirstclinicalexperience