In:
Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, SAGE Publications, Vol. 28, No. 3_suppl ( 2008-06), p. 117-122
Abstract:
In vitro studies of peritoneal dialysis (PD) solutions demonstrated that a lactate-buffered fluid with neutral pH and low glucose degradation products (LF) has better biocompatibility than a conventional acidic lactate-buffered fluid (CF). However, few clinical trials have evaluated the long-term benefit of the biocompatible solution on residual renal function (RRF). To compare LF with CF, we performed a prospective, randomized study with patients starting PD. ⋄ Patients and Methods After 1-month run-in period, 91 new PD patients were randomized for 12 months of treatment with either LF (Balance: Fresenius Medical Care, Bad Homburg, Germany; n = 48) or CF (Stay•Safe: Fresenius; n = 43). We measured RRF, acid–base balance, peritoneal equilibration test, and adequacy of dialysis every 6 months after the run-in period. ⋄ Results After 12 months of treatment, the residual glomerular filtration rate (GFR) in patients using LF tended to be higher than that of patients on CF ( p = 0.057 by repeated-measures analysis of variance). We observed a significant difference in the changes of residual GFR between the two groups ( p = 0.009), a difference that was especially marked in the subgroup whose baseline residual GFR was more than 2 mL/min/1.73 m 2 . In addition, serum total CO 2 levels were higher ( p = 0.001) and serum anion gap was lower ( p = 0.019) in the LF group. We observed no differences between groups for Kt/V, C-reactive protein, or normalized protein equivalent of nitrogen appearance. ⋄ Conclusions In incident PD patients with significant residual GFR, LF may better preserve RRF over a 12-month treatment period. Additionally, pH-neutral PD fluid may improve acid–base balance as compared with CF.
Type of Medium:
Online Resource
ISSN:
0896-8608
,
1718-4304
DOI:
10.1177/089686080802803s22
Language:
English
Publisher:
SAGE Publications
Publication Date:
2008
detail.hit.zdb_id:
2075957-5
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