The effect of glucose polymers on water removal and protein clearances during CAPD.
Two selected groups of 5 continuous ambulatory peritoneal dialysis (CAPD) patients (3 female, 7 male), mean age 60 years, were studied twice with an interval of 4 weeks. The first study was done with glucose-containing dialysate and the second study with dialysate containing glucose polymers (Dextrin 7.5%) after they had been treated with this solution (night dwell) for 4 weeks. The patients collected night bags for 3 consecutive days during the tests. Protein clearances were determined for beta 2-microglobulin, albumin, IgG, fibronectin, and alpha 2-macroglobulin in both periods to examine the influence of crystalloid-induced convection versus "colloid"-induced convection. Group I normally used 1.50% glucose and was therefore considered to have a "high ultrafiltration";group II was the "low ultrafiltration" group because they needed 4.25% glucose dialysate. For their usual glucose solutions the net ultrafiltration was not different between both groups, but the clearance of beta 2-microglobulin was higher in group II:839 +/- 98 microL/min (group I) and 1135 +/- 131 microL/min (group II) (p = 0.08). For glucose polymers the net ultrafiltration increased in both groups, but this was more pronounced in group II: 657 +/- 104 mL (group I) and 918 +/- 85 mL (group II) (p = 0.06). Also, the clearance of beta 2-microglobulin increased with the glucose polymer solution: 1268 +/- 94 microL/min (for glucose polymer) and 987 +/- 85 microL/min (for glucose) (p < 0.05), but the clearances of the larger serum proteins remained unaffected.(ABSTRACT TRUNCATED AT 250 WORDS)
Imholz
A L
AL
Department of Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Brown
C B
CB
Koomen
G C
GC
Arisz
L
L
Krediet
R T
RT
D000368:Aged; D000418:Albumins / Q000378:metabolism; D001798:Blood Proteins / Q000378:metabolism*; D003912:Dextrins / Q000008:administration & dosage / Q000494:pharmacology*; D015314:Dialysis Solutions; D005260:Female; D005353:Fibronectins / Q000378:metabolism; D005947:Glucose; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D014462:Ultrafiltration; D000511:alpha-Macroglobulins / Q000378:metabolism; D001613:beta 2-Microglobulin / Q000378:metabolism
D000418:Albumins; D001798:Blood Proteins; D003912:Dextrins; D015314:Dialysis Solutions; D005353:Fibronectins; D007074:Immunoglobulin G; D000511:alpha-Macroglobulins; D001613:beta 2-Microglobulin; D005947:Glucose