N-Acetylglucosamine- an osmotic slute for peritoneal dialysis without inducing hyperinsulinemia.
METHODS
N-Acetylglucosamine (NAG) was compared to glucose as an osmotic solute during peritoneal dialysis in rats. The effect of the tested solutes on blood glucose and insulin levels during dialysis was evaluated.


RESULTS
During 6-hour exchange with NAG (220 mmol/l) solution, the dialysate volume was higher than in rats dialyzed with fluid containing glucose (220 mmol/l; GLU: 34.5 +/- 1.7 vs. 32.8 +/- 1.1 ml, respectively; p < 0.05). The peritoneal permeability to protein (D/S x 1,000) was lower in the NAG group (9.7 +/- 2.5 vs. 16.3 +/- 5.6 in GLU; p < 0.02). Dialysis with GLU-based solution resulted in hyperglycemia up to 180 +/- 39 mg/dl; in the NAG group the increase in the blood glucose level was moderate (up to 91 +/- 9 mg/dl; p < 0.001). Dialysis with GLU fluid caused an increase in blood insulin level by 53.2 +/- 62.4 pmol/l, whereas the insulin blood concentration in NAG-treated animals was increased by 5.0 +/- 5.4 pmol/l (p < 0.001).


CONCLUSIONS
NAG is more effective than GLU osmotic solute during peritoneal dialysis and it reduces peritoneal permeability to protein. Dialysis with NAG results in lower hyperglycemia and hyperinsulinemia, both effects are favorable in diabetic peritoneal dialysis patients.
Breborowicz
A
A
Department of Pathophysiology, Poznan Medical School, Poznan, Poland. abreb@am.poznan.pl
Połubińska
A
A
Simon
M
M
Tam
P
P
Wu
G
G
D000117:Acetylglucosamine / Q000494:pharmacology* / Q000627:therapeutic use; D000327:Adsorption; D000818:Animals; D001786:Blood Glucose; D015314:Dialysis Solutions / Q000737:chemistry*; D005947:Glucose / Q000494:pharmacology; D005990:Glycerol / Q000494:pharmacology; D006946:Hyperinsulinism / Q000517:prevention & control; D007328:Insulin / Q000097:blood; D008297:Male; D009995:Osmosis; D010530:Peritoneal Dialysis / Q000379:methods*; D051381:Rats; D017208:Rats, Wistar; D014867:Water
D001786:Blood Glucose; D015314:Dialysis Solutions; D007328:Insulin; D014867:Water; D005947:Glucose; D005990:Glycerol; D000117:Acetylglucosamine