Relationship between effluent levels of beta(2)-microglobulin and peritoneal injury markers in 7.5% icodextrin-based peritoneal dialysis solution.
The removal of low molecular weight proteins such as beta(2)-microglobulin (beta(2)MG) is accelerated by using a 7.5% icodextrin-based peritoneal dialysis solution (ICO) dwell. To examine the possibility of peritoneal injury in ICO, we investigated the relationship between beta(2)MG and the injury markers in effluent. Sixteen ICO-treated patients (11 male and five female, mean age 50.1 +/- 10.9 years) with continuous ambulatory peritoneal dialysis (CAPD; mean duration 54.6 +/- 30.8 months) were studied. The patients were treated with ICO 2 L and 2.27% glucose-based solution 2 L for an 8-h dwell and the effluent was collected. We investigated the correlations between beta(2)MG and the injury markers (e.g. hyaluronic acid [HA], interleukin-6 [IL-6], matrix metalloproteinase-2 [MMP-2]) in each effluent sample. The beta(2)MG level in the ICO effluent was 8978 +/- 2431 microg/L, significantly higher than in the 2.27% glucose-based solution effluent (6454 +/- 2956 microg/L; P = 0.0032). The levels of HA and MMP-2 in ICO effluent were significantly higher than those in the 2.27% glucose-based solution effluent (P = 0.00214, P = 0.0113, respectively). There was a trend toward higher IL-6-values in ICO effluent, although no significant differences were seen. There were positive correlations between levels of various injury markers and beta(2)MG. We propose that the subclinical injury of the peritoneum by ICO treatment may accelerate peritoneal permeability to increase beta(2)MG in effluent. ICO's biocompatibility might not be superior to that of glucose-based solution.
Department of Internal Medicine, Division of Nephrology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan. satoshim@hsp.md.shinshu-u.ac.jp
Satoshi
S
Minami
Kazuhiko
K
Hora
Yuji
Y
Kamijo
Makoto
M
Higuchi
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000494:pharmacology; D005260:Female; D005936:Glucans / Q000494:pharmacology*; D005947:Glucose / Q000494:pharmacology*; D015312:Hemodialysis Solutions / Q000737:chemistry / Q000494:pharmacology*; D006801:Humans; D000077607:Icodextrin; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010537:Peritoneum / Q000187:drug effects*; D001613:beta 2-Microglobulin / Q000032:analysis*
D001672:Biocompatible Materials; D005936:Glucans; D015312:Hemodialysis Solutions; D001613:beta 2-Microglobulin; D000077607:Icodextrin; D005947:Glucose