Effects of neutral pH and low-glucose degradation product-containing peritoneal dialysis fluid on systemic markers of inflammation and endothelial dysfunction: a randomized controlled 1-year follow-up study

Park, Sun-Hee; Do, Jun‐Young; Kim, Yeong Hoon; Lee, Ho Yung; Kim, Beom Seok; Shin, Sug-Kyun; Kim, Hyun-Chul; Chang, Yoon-Kyung; Yang, Jong‐Oh; Chung, Hyun-Chul; Kim, Chan‐Duck; Lee, Won Kee; Kim, Jong-Yeon; Kim, Yong-Lim

doi:10.1093/ndt/gfr451

Cited by 34 publications

(51 citation statements)

References 31 publications

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“…Two among the final 12 studies were performed by Kim et al One showed the result at 12 months and the more recent study showed the result at 24 months with the same patients (28). Therefore, we applied the result only at 24 months, and the SR was conducted on the final 11 studies (1,034 patients) (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)43,44) (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

Effect of Biocompatible Peritoneal Dialysis Solution on Residual Renal Function: A Systematic Review of Randomized Controlled Trials

Seo

Cho

et al. 2014

Perit Dial Int

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♦ Introduction: Residual renal function (RRF) plays an important role in outcome of peritoneal dialysis (PD) including mortality. It is, therefore, important to provide a strategy for the preservation of RRF. The objective of this study was to evaluate relative protective effects of new glucose-based multicompartmental PD solution (PDS), which is well known to be more biocompatible than glucosebased conventional PDS, on RRF compared to conventional PDS by performing a systematic review (SR) of randomized controlled trials. ♦ Methods: We searched studies presented up to January 2014 in MEDLINE, EMBASE, the COCHRANE library, and local databases. Three independent reviewers reviewed and extracted prespecified data from each study. The random effects model, a more conservative analysis model, was used to combine trials and to perform stratified analyses based on the duration of follow-up. Study quality was assessed using the Cochrane Handbook for risk of bias. Eleven articles with 1,034 patients were identified for the SR.

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Section: Resultsmentioning

confidence: 99%

Effect of Biocompatible Peritoneal Dialysis Solution on Residual Renal Function: A Systematic Review of Randomized Controlled Trials

Seo

Cho

et al. 2014

Perit Dial Int

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“…The differences between our results and those of the prior published metaanalyses are likely caused by study selection. We included two large trials in our analysis that were not included in the analysis by Cho et al (23,24) (studies by Cho et al [12] and Park et al [20]). These studies (12,20) were published after the meta-analysis by Cho et al (23,24) was published and added over 200 patients.…”

Section: Discussionmentioning

confidence: 99%

“…Two reviewers independently screened references on the basis of the title and abstract, from which 161 studies were selected for full-text review. Eleven studies were included in the final analysis (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) (Figure 1). …”

Section: Trial Flowmentioning

confidence: 99%

Effect of Neutral-pH, Low–Glucose Degradation Product Peritoneal Dialysis Solutions on Residual Renal Function, Urine Volume, and Ultrafiltration

Yohanna

Alkatheeri

Brimble

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Neutral-pH, low-glucose degradation products solutions were developed in an attempt to lessen the adverse effects of conventional peritoneal dialysis solutions. A systematic review was performed evaluating the effect of these solutions on residual renal function, urine volume, peritoneal ultrafiltration, and peritoneal small-solute transport (dialysate to plasma creatinine ratio) over time.Design, setting, participants, & measurements Multiple electronic databases were searched from January of 1995 to January of 2013. Randomized trials reporting on any of four prespecified outcomes were selected by consensus among multiple reviewers.Results Eleven trials of 643 patients were included. Trials were generally of poor quality. The meta-analysis was performed using a random effects model. The use of neutral-pH, low-glucose degradation products solutions resulted in better preserved residual renal function at various study durations, including .1 year (combined analysis: 11 studies; 643 patients; standardized mean difference =0.17 ml/min; 95% confidence interval, 0.01 to 0.32), and greater urine volumes (eight studies; 598 patients; mean difference =128 ml/d; 95% confidence interval, 58 to 198). There was no significant difference in peritoneal ultrafiltration (seven studies; 571 patients; mean difference =2110; 95% confidence interval, 2312 to 91) or dialysate to plasma creatinine ratio (six studies; 432 patients; mean difference =0.03; 95% confidence interval, 0.00 to 0.06).Conclusions The use of neutral-pH, low-glucose degradation products solutions results in better preservation of residual renal function and greater urine volumes. The effect on residual renal function occurred early and persisted beyond 12 months. Additional studies are required to evaluate the use of neutral-pH, low-glucose degradation products solutions on hard clinical outcomes.

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“…Previous studies reported conflicting results regarding the effect of low GDP dialysate on RRF [23,24,25,26,27,28,29,30]. These studies have many limitations such as study design, high drop-out rate, statistical error, lack of data for peritoneal ultrafiltration, and low baseline RRF.…”

Section: Discussionmentioning

confidence: 99%

Proteinuria as a Risk Factor for Decline in Residual Renal Function in Non-Diabetic Peritoneal Dialysis Patients

Kang

Cho²,

Park³

et al. 2013

Kidney Blood Press Res

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Background: Preservation of residual renal function (RRF) is a major issue for patients on peritoneal dialysis (PD). Whether proteinuria is associated with a decline in RRF in patients on PD remains unclear. Patients and Methods: We reviewed the medical records at the Yeungnam University Hospital in Korea and identified patients who started PD between June 1995 and August 2011. A total of 147 non-diabetic patients were enrolled in the study. The patients were divided into 3 groups with respect to the tertile of initial proteinuria level: Low (n = 49; <320 mg/day), Middle (n = 49; 320-822 mg/day), and High groups (n = 49; >822 mg/day). Results: The mean patient age was 50.2 ± 15.0 years in the Low tertile, 50.2 ± 15.4 years in the Middle tertile, and 49.0 ± 15.1 years in the High tertile. Decline in RRF during follow-up period was greater in the High tertile than that in the other tertiles (P = 0.001). The proportion of patients with RRF >50% of baseline at 24 months after the initiation of PD was 83% in the Low tertile, 66% in the Middle tertile, and 40% in the High tertile (P < 0.001). The multivariate analysis after adjusting for initial RRF, age, gender, underlying disease of end-stage renal disease except diabetes mellitus, PD modality, use of icodextrin, PD-associated peritonitis, and tertile of the initial proteinuria level revealed that High tertile of the initial proteinuria level was associated with a decline in RRF (hazard ratios: 2.442 for the Middle tertile, P = 0.007 ; 3.713 for the Low tertile, P < 0.001). Conclusion: The present study demonstrates that proteinuria may be is associated with a rapid decline in RRF in non-diabetic patients on PD, although the potential role of additional factors should be further investigated in prospective studies.

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Effects of neutral pH and low-glucose degradation product-containing peritoneal dialysis fluid on systemic markers of inflammation and endothelial dysfunction: a randomized controlled 1-year follow-up study

Abstract: Neutral pH and low-GDP PDF likely produce fewer changes in markers of endothelial dysfunction compared to conventional PDF in incident PD patients.

Cited by 34 publications

References 31 publications

Effect of Biocompatible Peritoneal Dialysis Solution on Residual Renal Function: A Systematic Review of Randomized Controlled Trials

Effect of Biocompatible Peritoneal Dialysis Solution on Residual Renal Function: A Systematic Review of Randomized Controlled Trials

Effect of Neutral-pH, Low–Glucose Degradation Product Peritoneal Dialysis Solutions on Residual Renal Function, Urine Volume, and Ultrafiltration

Proteinuria as a Risk Factor for Decline in Residual Renal Function in Non-Diabetic Peritoneal Dialysis Patients

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