Biocompatible peritoneal dialysis solution preserves residual renal function

Am J Nephrol. 2012;36(4):305-16. doi: 10.1159/000342523. Epub 2012 Sep 22.

Abstract

Background/aims: The long-term effects of biocompatible peritoneal dialysis (PD) solution on residual renal function (RRF), inflammation, adipokines and metabolic acidosis are controversial. We evaluated the effects of biocompatible PD solution in continuous ambulatory PD (CAPD) patients for an additional 12-month period.

Method: Among 91 incident patients who started CAPD with either biocompatible PD solution (Balance®, Fresenius; LS, n = 48) or conventional PD solution (CAPD/DPCA®, Fresenius; CS, n = 43), 63 patients, who were followed for 12 months, were enrolled and followed for an additional 12 months.

Results: After 24 months of treatment, the glomerular filtration rate (GFR) of the LS group was twofold higher compared to the CS group (33.5 ± 30.7 vs. 16.3 ± 17.9 l/week/1.73 m(2), respectively, p = 0.021). In a subgroup of patients with an initial GFR >2 ml/min/1.73 m(2), the GFR of the LS group was significantly higher than the rate of the CS group after 24 months (43.7 ± 30.5 vs. 18.6 ± 19.0 l/week/1.73 m(2), respectively, p = 0.042). Over a 24-month period, effluent cancer antigen-125 levels were significantly increased in the LS group compared to the CS group, while effluent interleukin-6 levels did not differ between the two groups. The serum tCO(2) levels were consistently higher in the LS group compared to the CS group.

Conclusions: We found that the effect of LS on preserving RRF may be maintained over a 24-month treatment period in CAPD patients, and LS use may have other benefits, such as the correction of metabolic acidosis.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acidosis / metabolism
  • Acidosis / therapy
  • Adipokines / metabolism
  • Adult
  • Aged
  • Biocompatible Materials / administration & dosage
  • Biocompatible Materials / metabolism
  • Biomarkers / metabolism
  • Comorbidity
  • Dialysis Solutions / administration & dosage*
  • Dialysis Solutions / metabolism
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate / physiology
  • Glycation End Products, Advanced / metabolism
  • Humans
  • Kidney / physiology*
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / physiopathology*
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Peritoneal Dialysis, Continuous Ambulatory / methods*
  • Peritoneum / physiology
  • Peritonitis / mortality
  • Prospective Studies
  • Risk Factors

Substances

  • Adipokines
  • Biocompatible Materials
  • Biomarkers
  • Dialysis Solutions
  • Glycation End Products, Advanced