Comparison of Longitudinal Membrane Function in Peritoneal Dialysis Patients According to Dialysis Fluid Biocompatibility
| Autor: | R. T. Krediet, Cynthia J. Janmaat, A. M. Coester, A. T. N. van Diepen, Dirk G. Struijk, Friedo W. Dekker |
|---|---|
| Přispěvatelé: | Nephrology, ACS - Diabetes & metabolism, Faculteit Medische Wetenschappen/UMCG |
| Rok vydání: | 2020 |
| Předmět: |
Nephrology
MESOTHELIAL CELL medicine.medical_specialty Biocompatibility medicine.medical_treatment RESIDUAL RENAL-FUNCTION 030232 urology & nephrology Ultrafiltration Urology Peritonitis DETERMINANTS 030204 cardiovascular system & hematology ULTRAFILTRATION Peritoneal dialysis 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Clinical Research Internal medicine medicine GLUCOSE DEGRADATION-PRODUCTS peritonitis Dialysis peritoneal transport Creatinine business.industry NEUTRAL-PH dialysis solution Fluid transport medicine.disease SMALL-SOLUTE TRANSPORT FREE-WATER TRANSPORT peritoneal dialysis chemistry TIME-COURSE long-term renal replacement therapy GLYCATION END-PRODUCTS business |
| Zdroj: | Kidney International Reports, 5(12), 2183-2194. Elsevier Inc. Kidney International Reports Kidney International Reports, 5(12), 2183-2194. ELSEVIER SCIENCE INC |
| ISSN: | 2468-0249 |
| Popis: | Introduction Preservation of peritoneal function is essential in long-term peritoneal dialysis. Biocompatible dialysis solutions might prevent or postpone the membrane alteration resulting in ultrafiltration failure and consecutive morbidity and mortality. Methods We conducted an observational cohort study in which we made a longitudinal comparison between the course of peritoneal solute and fluid transport during treatment with conventional and biocompatible solutions. Therefore, prospectively collected peritoneal transport data from the yearly standard peritoneal permeability analysis were analyzed in 251 incident patients treated between 1994 and censoring in 2016. Fluid transport included small pore and free water transport. Solute transport was assessed by creatinine mass transfer area coefficient and glucose absorption. Linear mixed models including change point analyses were performed. Interaction with peritonitis was examined. Results One hundred thirty-five patients received conventional and 116 biocompatible solutions. Sixty-seven percent (conventional) and 64% (biocompatible) of these underwent minimally three transport measurements. Initially, biocompatible fluids showed higher small solute transport and lower ultrafiltration than conventional fluids up to 3 years. Thereafter, conventional fluids showed an increase in small solute transport (+2.7 ml/min per year; 95% confidence interval [CI]: 0.9 to 4.5) and a decrease of free water transport (−28.0 ml/min per year; 95% CI: −60.4 to 4.4). These were minor or absent in biocompatible treatment. Peritonitis induced a decrease of transcapillary ultrafiltration after 2 years on dialysis with conventional solutions (−291 ml/min per year; 95% CI: −550 to −32) while this was absent in biocompatible treatment. Conclusion Despite a higher initial solute transport with biocompatible solutions, these have less influence on functional long-term peritoneal alterations than conventional solutions. Graphical abstract |
| Databáze: | OpenAIRE |
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