title: The effect of low-GDP solution on ultrafiltration and solute transport in continuous ambulatory peritoneal dialysis patients.
abstract: BACKGROUND
  Several studies have reported benefits for human peritoneal mesothelial cell function of a neutral-pH dialysate low in glucose degradation products (GDPs). However, the effects of low-GDP solution on ultrafiltration (UF), transport of solutes, and control of body water remain elusive. We therefore investigated the effect of low-GDP solution on UF, solute transport, and control of body water.
  
  
  METHODS
  Among 79 new continuous ambulatory peritoneal dialysis (CAPD) patients, 60 completed a 12-month protocol (28 in a lactate-based high-GDP solution group, 32 in a lactate-based low-GDP solution group). Clinical indices--including 24-hour UF volume (UFV), 24-hour urine volume (UV), residual renal function, and dialysis adequacy--were measured at months 1, 6, and 12. At months 1, 6, and 12, UFV, glucose absorption, 4-hour dialysate-to-plasma (D/P) creatinine, and 1-hour D/P Na(+) were assessed during a modified 4.25% peritoneal equilibration test (PET). Body composition by bioelectric impedance analysis was measured at months 1 and 12 in 26 CAPD patients.
  
  
  RESULTS
  Daily UFV was lower in the low-GDP group. Despite similar solute transport and aquaporin function, the low-GDP group also showed lower UFV and higher glucose absorption during the PET. Factors associated with UFV during the PET were lactate-based high-GDP solution and 1-hour D/P Na(+). No differences in volume status and obesity at month 12 were observed, and improvements in hypervolemia were equal in both groups.
  
  
  CONCLUSIONS
  Compared with the high-GDP group, the low-GDP group had a lower UFV during a PET and a lower daily UFV during the first year after peritoneal dialysis initiation. Although the low-GDP group had a lower daily UFV, no difficulties in controlling edema were encountered.
authors.affiliation: Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea.
authors.forename: Kyu-Hyang
authors.initials: KH
authors.lastname: Cho
authors.forename: Jun-Young
authors.initials: JY
authors.lastname: Do
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Park
authors.forename: Kyung-Woo
authors.initials: KW
authors.lastname: Yoon
authors.forename: Yong-Lim
authors.initials: YL
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001692:Biological Transport; D001823:Body Composition; D015314:Dialysis Solutions / Q000737:chemistry*; D017097:Electric Impedance; D005260:Female; D005947:Glucose / Q000032:analysis*; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011446:Prospective Studies; D014462:Ultrafiltration
chemical_list: D015314:Dialysis Solutions; D015850:Interleukin-6; D005947:Glucose
keywords: Low-GDP solution; solute transport; ultrafiltration