Combination of Crystalloid (Glucose) and Colloid (Icodextrin) Osmotic Agents Markedly Enhances Peritoneal Fluid and Solute Transport during the Long PD Dwell
| Autor: | Andrzej Werynski, Jose C. Divino Filho, Philippe Freida, Bengt Lindholm, Magda Galach |
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| Rok vydání: | 2007 |
| Předmět: |
Peritoneal fluid
medicine.medical_treatment Sodium 030232 urology & nephrology chemistry.chemical_element General Medicine Osmosis Icodextrin Peritoneal dialysis Osmolar Concentration 03 medical and health sciences Ultrafiltration (renal) Colloid 0302 clinical medicine chemistry Biochemistry Nephrology medicine Biophysics 030212 general & internal medicine |
| Zdroj: | Karolinska Institutet |
| ISSN: | 1718-4304 0896-8608 |
| DOI: | 10.1177/089686080702700311 |
| Popis: | Background Fluid and sodium removal is often inadequate in peritoneal dialysis patients with high peritoneal solute transport rate, especially when residual renal function is declining. Method We studied the effects of using simultaneous crystalloid (glucose) and colloid (icodextrin) osmotic agents on the peritoneal transport of fluid, sodium, and other solutes during 15-hour single-dwell exchanges using 3.86% glucose, 7.5% icodextrin, and a combination fluid with 2.61% glucose and 6.8% icodextrin in 7 prevalent peritoneal dialysis patients with fast peritoneal solute transport rate. Results The combination fluid enhanced net ultrafiltration (mean 990 mL) and sodium removal (mean 158 mmol) compared with 7.5% icodextrin (mean net ultrafiltration 462 mL, mean net sodium removal 49 mmol). In contrast, the 3.86% glucose-based solution yielded negligible ultra-filtration (mean -85 mL) and sodium removal (mean 16 mmol). The combination solution resulted in significantly improved urea (+41%) and creatinine (+26%) clearances compared with 7.5% icodextrin. Conclusion A solution containing both crystalloid (glucose 2.61%) and colloid (icodextrin 6.8%) osmotic agents enhanced fluid removal by twofold and sodium removal by threefold compared with 7.5% icodextrin solution during a dwell of 15 hours, indicating that such a combination solution could represent a new treatment option for anuric peritoneal dialysis patients with high peritoneal solute transport rate. |
| Databáze: | OpenAIRE |
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