Glucoregulatory hormones and choice of osmotic agent in peritoneal dialysis.
OBJECTIVE
The present study was performed to explore the range of effects of amino acid-based peritoneal dialysis (PD) solutions on glucoregulatory hormones in comparison with an osmotically equivalent glucose-based solution. ♢


METHODS
13 adult nondiabetic patients on PD underwent 2 peritoneal dwells of 2 hours' duration with either 1.5% dextrose solution or 1.1% amino acid solution. Serial sampling for glucoregulatory hormones was done throughout the duration of the dwell. ♢


RESULTS
Instillation of the 1.5% dextrose solution resulted in a modest change in plasma glucose, paralleled by a small increase in plasma insulin levels and plasma insulin-like growth factor (IGF-1). Plasma glucagon was not changed and plasma growth hormone level declined. Instillation of the 1.1% amino acid solution resulted in an increase in plasma glucose, plasma insulin, plasma glucagon, and plasma IGF-1. Plasma growth hormone level declined. Both solutions led to an increase in plasma norepinephrine but no changes were observed in epinephrine or dopamine. ♢


CONCLUSIONS
Our observations suggest that the mere replacement of glucose by amino acids in PD solutions does not necessarily imply "glucose sparing" from the perspective of induction of a glucoregulatory hormonal response because of the aminogenic stimulation of secretion of multiple hormones.
Mujais
Salim
S
Astellas Pharma Global Development, Deerfield, Illinois, USA.
Tapiawala
Shruti N
SN
Yip
Paul
P
Al-Rowaie
Fadel
F
Burdzy
Dorothy
D
Bargman
Joanne M
JM
Oreopoulos
Dimitrios G
DG
D000328:Adult; D000368:Aged; D000596:Amino Acids / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D003404:Creatinine / Q000032:analysis; D015314:Dialysis Solutions / Q000627:therapeutic use*; D004298:Dopamine / Q000097:blood; D004837:Epinephrine / Q000097:blood; D005260:Female; D005934:Glucagon / Q000097:blood; D005947:Glucose / Q000032:analysis / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D036361:Peptide Hormones / Q000032:analysis*; D010530:Peritoneal Dialysis; D011446:Prospective Studies; D012964:Sodium / Q000032:analysis; D014508:Urea / Q000032:analysis; D055815:Young Adult
D000596:Amino Acids; D001786:Blood Glucose; D002096:C-Peptide; D015314:Dialysis Solutions; D007328:Insulin; C482915:Nutrineal; D036361:Peptide Hormones; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D014508:Urea; D005934:Glucagon; D012964:Sodium; D003404:Creatinine; D005947:Glucose; D004298:Dopamine; D009638:Norepinephrine; D004837:Epinephrine