title: Impact of a low-glucose peritoneal dialysis regimen on fibrosis and inflammation biomarkers.
abstract: BACKGROUND
  The impact of a low-glucose peritoneal dialysis (PD) regimen on biomarkers of peritoneal inflammation, fibrosis and membrane integrity remains to be investigated.
  
  
  METHODS
  In a randomized, prospective study, 80 incident PD patients received either a low-glucose regimen comprising Physioneal (P), Extraneal (E) and Nutrineal (N) (Baxter Healthcare Corporation, Deerfield, IL, USA) (PEN group), or Dianeal (control group) for 12 months, after which both groups continued with Dianeal dialysis for 6 months. Serum and dialysate levels of vascular endothelial growth factor (VEGF), decorin, hepatocyte growth factor (HGF), interleukin-6 (IL-6), macrophage migration inhibitory factor (MIF), hyaluronan (HA), adiponectin, soluble-intracellular adhesion molecule (s-ICAM), vascular cell adhesion molecule-1 (VCAM-1) and P-selectin, and dialysate cancer antigen 125 (CA125), were measured after 12 and 18 months. This paper focuses on results after 12 months, when patients in the PEN group changed to glucose-based PD fluid (PDF).
  
  
  RESULTS
  At the end of 12 months, effluent dialysate levels of CA125, decorin, HGF, IL-6, adiponectin and adhesion molecules were significantly higher in the PEN group compared to controls, but all decreased after patients switched to glucose-based PDF. Macrophage migration inhibitory factor level was lower in the PEN group but increased after changing to glucose-based PDF and was similar to controls at 18 months. Serum adiponectin level was higher in the PEN group at 12 months, but was similar in the 2 groups at 18 months. Body weight, residual renal function, ultrafiltration volume and total Kt/V did not differ between both groups. Dialysate-to-plasma creatinine ratio at 4 h was higher in the PEN group at 12 months and remained so after switching to glucose-based PDF.
  
  
  CONCLUSIONS
  Changes in the biomarkers suggest that the PEN PD regimen may be associated with better preservation of peritoneal membrane integrity and reduced systemic vascular endothelial injury.
authors.affiliation: Department of Medicine, University of Hong Kong, Hong Kong.
authors.forename: Susan
authors.initials: S
authors.lastname: Yung
authors.affiliation: Tung Wah Hospital, Hong Kong.
authors.forename: Sing Leung
authors.initials: SL
authors.lastname: Lui
authors.affiliation: Department of Medicine, University of Hong Kong, Hong Kong.
authors.forename: Chris K F
authors.initials: CK
authors.lastname: Ng
authors.affiliation: Department of Medicine, University of Hong Kong, Hong Kong.
authors.forename: Andrew
authors.initials: A
authors.lastname: Yim
authors.affiliation: Queen Mary Hospital, Hong Kong.
authors.forename: Maggie K M
authors.initials: MK
authors.lastname: Ma
authors.affiliation: Kwong Wah Hospital, Hong Kong.
authors.forename: Kin Yee
authors.initials: KY
authors.lastname: Lo
authors.affiliation: Pamela Youde Nethersole Eastern Hospital, Hong Kong.
authors.forename: Chik Cheung
authors.initials: CC
authors.lastname: Chow
authors.affiliation: Princess Margaret Hospital, Hong Kong.
authors.forename: Kwok Hong
authors.initials: KH
authors.lastname: Chu
authors.affiliation: Queen Elizabeth Hospital, Hong Kong.
authors.forename: Wai Leung
authors.initials: WL
authors.lastname: Chak
authors.affiliation: Queen Mary Hospital, Hong Kong.
authors.forename: Man Fai
authors.initials: MF
authors.lastname: Lam
authors.affiliation: Tuen Mun Hospital, Hong Kong.
authors.forename: Chun Yu
authors.initials: CY
authors.lastname: Yung
authors.affiliation: Tung Wah Hospital, Hong Kong.
authors.forename: Terence P S
authors.initials: TP
authors.lastname: Yip
authors.affiliation: United Christian Hospital, Hong Kong.
authors.forename: Sunny
authors.initials: S
authors.lastname: Wong
authors.affiliation: Department of Medicine, University of Hong Kong, Hong Kong.
authors.forename: Colin S O
authors.initials: CS
authors.lastname: Tang
authors.affiliation: Department of Medicine, University of Hong Kong, Hong Kong Tung Wah Hospital, Hong Kong.
authors.forename: Flora S K
authors.initials: FS
authors.lastname: Ng
authors.affiliation: Department of Medicine, University of Hong Kong, Hong Kong Queen Mary Hospital, Hong Kong.
authors.forename: Tak Mao
authors.initials: TM
authors.lastname: Chan
mesh_terms: D000368:Aged; D000596:Amino Acids; D015415:Biomarkers / Q000097:blood; D015314:Dialysis Solutions; D005260:Female; D005936:Glucans; D005947:Glucose; D006801:Humans; D000077607:Icodextrin; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009930:Organic Chemicals; D010530:Peritoneal Dialysis; D056627:Peritoneal Fibrosis / Q000097:blood*; D010538:Peritonitis / Q000097:blood*; D011446:Prospective Studies
chemical_list: D000596:Amino Acids; D015415:Biomarkers; D015314:Dialysis Solutions; D005936:Glucans; C482915:Nutrineal; D009930:Organic Chemicals; C488052:Physioneal 35; D000077607:Icodextrin; D005947:Glucose
keywords: Amino acid; biocompatibility; icodextrin; pH neutral; peritoneal dialysis; peritoneal inflammation