Peritoneal clearance of homocysteine with icodextrin or standard glucose solution exchange.
BACKGROUND
The aim of the study was to assess plasma homocysteine concentration in peritoneal dialysis patients, and to compare the effect of different peritoneal solutions (glucose-based and icodextrin-based) on peritoneal clearance of homocysteine.


METHODS
The study group comprised 10 chronic peritoneal dialysis patients; the control group comprised 15 healthy, age-matched non-obese subjects with normal renal function. Patients with vitamin B(12) or folate deficiency were excluded. In all subjects, plasma homocysteine and dialysis adequacy parameters were assessed at baseline. The clearance study was carried out with 2.27% glucose and 7.5% icodextrin solutions (12-h dwell time).


RESULTS
Mean dialysate concentration of homocysteine was similar for both glucose and icodextrin solutions (8.3 +/- 3.2 and 8.4 +/- 1.9 micromol/L, respectively), but homocysteine clearance was significantly higher for icodextrin than glucose solution (1.82 +/- 0.57 vs 1.39 +/- 0.53 mL/min per 1.73 m(2)P = 0.01). Net ultrafiltration after icodextrin solution was also higher than after glucose solution (599 +/- 136 mL vs 134 +/- 337 mL, P < 0.01). A correlation between total plasma level of homocysteine and its peritoneal clearance was found (r = 0.69; P = 0.03).


CONCLUSIONS
It appears that peritoneal elimination of homocysteine depends primarily on its plasma concentration. Icodextrin-based solution for peritoneal dialysis seems to be more efficient in homocysteine elimination than a standard glucose-based solution.
Czupryniak
Aneta
A
Department of Nephrology and Dialysis, Polish Mother's Memorial Hospital Research Institute, Lódz, Poland.
Nowicki
Michal
M
Chwatko
Grazyna
G
Jander
Anna
A
Bald
Edward
E
D000328:Adult; D005260:Female; D005936:Glucans; D005947:Glucose; D015312:Hemodialysis Solutions / Q000737:chemistry*; D006710:Homocysteine / Q000097:blood / Q000378:metabolism*; D006801:Humans; D000077607:Icodextrin; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010537:Peritoneum / Q000378:metabolism*
D005936:Glucans; D015312:Hemodialysis Solutions; D006710:Homocysteine; D000077607:Icodextrin; D005947:Glucose