PMID- 18178947
OWN - NLM
STAT- MEDLINE
DCOM- 20080603
LR  - 20200109
IS  - 0896-8608 (Print)
IS  - 0896-8608 (Linking)
VI  - 28
IP  - 1
DP  - 2008 Jan-Feb
TI  - Short-term effects of a new bicarbonate/lactate-buffered and conventional 
      peritoneal dialysis fluid on peritoneal and systemic inflammation in CAPD 
      patients: a randomized controlled study.
PG  - 44-52
AB  - OBJECTIVES: This study was designed to compare the local peritoneal and systemic 
      inflammatory effects of a conventional lactate-based (Lac) peritoneal dialysis 
      (PD) solution and a new biocompatible bicarbonate/lactate-based (Bic/Lac) 
      solution having low concentration of glucose degradation products. METHODS: 26 
      stable, prevalent PD patients were enrolled in this prospective study. They 
      sequentially underwent 3 months of therapy with the Lac solution and 3 months 
      with the Bic/Lac solution in a randomized order. Flow cytometry was used to 
      measure the expression of inflammatory molecules on peritoneal cells in overnight 
      effluent collected at the end of each study period. RESULTS: 21 patients 
      successfully completed the study. Mean fluorescence intensity of human leukocyte 
      antigen (HLA)-DR and CD14 expression by macrophages were not different between 
      Lac and Bic/Lac. The peritoneal appearance rate of cancer antigen 125 (kU/minute) 
      was 68 +/- 37 with Lac and 133 +/- 66 with Bic/Lac (p < 0.001), and of 
      interleukin (IL)-6 (ng/minute), 0.28 +/- 0.2 with Lac and 0.18 +/- 0.16 with 
      Bic/Lac (p = 0.014). HLA-DR macrophage expression and IL-6 peritoneal appearance 
      rates did not correlate. Serum concentrations with Lac and Bic/Lac were, for 
      IL-6, 3.49 +/- 2.28 and 3.72 +/- 2.46 ng/L (p = 0.17), and for high-sensitivity 
      C-reactive protein, 2.31 +/- 2.98 and 2.71 +/- 3.31 mg/L (p = 0.32) respectively. 
      The concentration of effluent macrophages (x10(6)/L) with Lac was 1.6 +/- 1.6 and 
      with Bic/Lac 2.6 +/- 3.3 (p = 0.07). CONCLUSIONS: We conclude that, although 
      there was a significant reduction in peritoneal IL-6 in patients using Bic/Lac 
      solution, systemic levels of inflammatory markers did not differ between the two 
      solutions and no changes were present in macrophage surface activation markers, 
      suggesting perhaps a less important role of peritoneal macrophages in the 
      intraperitoneal chronic inflammatory process. The number of effluent macrophages 
      tended to be higher in patients using the Bic/Lac solution, possibly contributing 
      to improved intraperitoneal defense.
FAU - Pajek, Jernej
AU  - Pajek J
AD  - Department of Nephrology, University Medical Center Ljubljana, Slovenia. 
      jernej.pajek@mf.uni-lj.si
FAU - Kveder, Radoslav
AU  - Kveder R
FAU - Bren, Andrej
AU  - Bren A
FAU - Gucek, Andrej
AU  - Gucek A
FAU - Ihan, Alojz
AU  - Ihan A
FAU - Osredkar, Josko
AU  - Osredkar J
FAU - Lindholm, Bengt
AU  - Lindholm B
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Perit Dial Int
JT  - Peritoneal dialysis international : journal of the International Society for 
      Peritoneal Dialysis
JID - 8904033
RN  - 0 (Bicarbonates)
RN  - 0 (Buffers)
RN  - 0 (CA-125 Antigen)
RN  - 0 (Dialysis Solutions)
RN  - 0 (Interleukin-6)
RN  - 33X04XA5AT (Lactic Acid)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
CIN - Perit Dial Int. 2008 Jan-Feb;28(1):28-31. PMID: 18178944
MH  - Adult
MH  - Aged
MH  - Ascitic Fluid/metabolism
MH  - Bicarbonates/*pharmacology
MH  - Buffers
MH  - C-Reactive Protein/metabolism
MH  - CA-125 Antigen/metabolism
MH  - Cross-Over Studies
MH  - Dialysis Solutions/*pharmacology
MH  - Female
MH  - Flow Cytometry
MH  - Humans
MH  - Interleukin-6/metabolism
MH  - Lactic Acid/*pharmacology
MH  - Macrophages/metabolism
MH  - Male
MH  - Middle Aged
MH  - Peritoneal Dialysis, Continuous Ambulatory/*methods
MH  - Peritonitis/*physiopathology
MH  - Prospective Studies
MH  - Time Factors
EDAT- 2008/01/08 09:00
MHDA- 2008/06/05 09:00
CRDT- 2008/01/08 09:00
PHST- 2008/01/08 09:00 [pubmed]
PHST- 2008/06/05 09:00 [medline]
PHST- 2008/01/08 09:00 [entrez]
AID - 28/1/44 [pii]
PST - ppublish
SO  - Perit Dial Int. 2008 Jan-Feb;28(1):44-52.