title: Saccharides as osmotic agents in peritoneal dialysate: determination of molecular weight essential for more efficient fluid removal.
abstract: Glucose has widely been used as an osmotic agent in continuous ambulatory peritoneal dialysis (CAPD) but owing to its low molecular weight (MW), ultrafiltration (UF) in a 6-hour dialysate exchange does not appear sufficient. Thus, in the present study, a search was made to find saccharides that would ensure optimal UF, exceeding that obtained with glucose in a 6-hour dwell period. Rats were intraperitoneally infused with peritoneal dialysate (20 mL/body) containing the same molar concentrations (75.5 mM, 126 mM, or 204 mM) of various osmotic agents including glucose (monosaccharide, MW = 180.16) at concentrations of 1.36%, 2.27%, and 3.86%; maltose (disaccharide, MW = 342.30) at concentrations of 2.58% and 4.32%; maltotriose (trisaccharide, MW = 504.44), at concentrations of 3.81% and 6.36%; and maltopentaose (pentasaccharide, MW = 828.72) at concentrations of 6.26% and 10.4%. Intraperitoneal-fluid volume was measured at 1, 2, 3, 4, and 6 hours. With glucose as the osmotic agent, maximal UF was noted at 2 to 4 hours. UF was more efficient at 6 hours with maltotriose or maltopentaose as the osmotic agent. Even with a trisaccharide or pentasaccharide (molecular weights of 500 to 830), UF at 6 hours was found more efficient, as evidenced by the delay in peritoneal absorption. Fluid removal in 6 hours should be greater when using a dialysate containing oligosaccharides such as maltotriose or maltopentaose in place of glucose.
authors.affiliation: Kidney Center, Kitasato University Hospital, Kanagawa, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yokota
authors.forename: K
authors.initials: K
authors.lastname: Kumano
authors.forename: P
authors.initials: P
authors.lastname: Ma
authors.forename: T
authors.initials: T
authors.lastname: Hyodo
authors.forename: T
authors.initials: T
authors.lastname: Sakai
authors.forename: G
authors.initials: G
authors.lastname: Izumi
authors.forename: A
authors.initials: A
authors.lastname: Hashimoto
authors.forename: K
authors.initials: K
authors.lastname: Shibata
authors.forename: H
authors.initials: H
authors.lastname: Wang
mesh_terms: D000818:Animals; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000378:metabolism; D015314:Dialysis Solutions / Q000008:administration & dosage / Q000737:chemistry*; D005947:Glucose / Q000737:chemistry; D008297:Male; D008320:Maltose / Q000737:chemistry; D008970:Molecular Weight; D009844:Oligosaccharides / Q000737:chemistry*; D009997:Osmotic Pressure; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010537:Peritoneum / Q000378:metabolism; D011506:Proteins / Q000378:metabolism; D051381:Rats; D011919:Rats, Inbred Strains; D013997:Time Factors; D014312:Trisaccharides / Q000737:chemistry
chemical_list: D015314:Dialysis Solutions; D009844:Oligosaccharides; D011506:Proteins; D014312:Trisaccharides; C019193:maltopentaose; C008317:maltotriose; D008320:Maltose; D003404:Creatinine; D005947:Glucose