Peritoneal dialysis solutions and systems

Feriani, M; Catizone, Luigi; A, Fracasso

doi:10.1007/978-94-017-3225-3_8

Cited by 11 publications

(9 citation statements)

References 244 publications

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“…Reduction of daily carbohydrate absorption through the use of icodextrin may help to reduce the risk of metabolic complications such as hyperinsulinemia, hyperlipidemia with elevated triglycerides and LDL cholesterol, appetite suppression, and obesity (20,21,26). Use of icodextrin in place of 4.25% dextrose would also reduce peritoneal glucose exposure, which may mitigate the detrimental effects of glucose on peritoneal membrane function (22) and extend the time that patients are able to use their PD modality of choice (8).…”

Section: Discussionmentioning

confidence: 99%

Superiority of Icodextrin Compared with 4.25% Dextrose for Peritoneal Ultrafiltration

Finkelstein¹,

Healy²,

Abu‐Alfa³

et al. 2005

Journal of the American Society of Nephrology

132

119

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Several clinical observations suggest the superiority of icodextrin compared with 4.25% dextrose in optimizing peritoneal ultrafiltration (UF), but no rigorous controlled evaluation has hitherto been performed. For comparing icodextrin and 4.25% dextrose during the long dwell of automated peritoneal dialysis, a multicenter, randomized, double-blind trial was conducted in 92 patients (control, 45; icodextrin, 47) with 4-h dialysate to plasma ratio creatinine >0.70 and D/D 0 glucose <0.34. Long-dwell net UF and the UF efficiency ratio (net UF volume per gram of dialysate carbohydrate absorbed) were determined at baseline, week 1, and week 2. The control and treatment groups were comparable at baseline (all patients using 4.25% dextrose for the long dwell) with regard to mean (؎SEM) net UF (201.7 ؎ 103.1 versus 141.6 ؎ 75.4 ml, respectively; P ‫؍‬ 0.637) and the percentage of patients with negative net UF (control, 37.8%; treatment, 42.6%; P ‫؍‬ 0.641). During the study period, net UF was unchanged from baseline in the control group but increased significantly (P < 0.001) in the icodextrin group from 141.6 ؎ 75.4 to 505.8 ؎ 46.8 ml at week 1 and 540.2 ؎ 46.8 ml at week 2. In the icodextrin group, the incidence of negative net UF was significantly lower (P < 0.0001) than in the control group. Findings were similar for UF efficiency ratio. Rash was reported significantly more often in the icodextrin group. This study showed that in high-average and high transporters, icodextrin is superior to 4.25% dextrose for long-dwell fluid and solute removal.

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Section: Discussionmentioning

confidence: 99%

Superiority of Icodextrin Compared with 4.25% Dextrose for Peritoneal Ultrafiltration

Finkelstein¹,

Healy²,

Abu‐Alfa³

et al. 2005

Journal of the American Society of Nephrology

132

119

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“…Potassium is removed from the intravascular compartment (IVC) to the dialysate, while intravascular potassium is replenished from the ICC. Since the former passage is faster than the latter, movement of potassium from ICC to IVC continues even after the end of dialysis, until a steady state is reestablished between these two compartments [1]. Therefore, after the end of a highly efficient hemodialysis, one should expect an increase in plasma potassium of 0.5-1 mmol, within 1-3 hours, if there was a marked change in plasma potassium during dialysis.…”

Section: Hemodialysismentioning

confidence: 95%

“…Usually, its removal is considered satisfactory if the pre and postdialysis plasma potassium levels are lower than 6 mmol/l and higher than 3.3 mmol/l, respectively [1]. Potassium clearance is similar to that of creatinine, but its rate of removal varies with the potassium gradient between plasma and dialysate.…”

Section: Hemodialysismentioning

confidence: 99%

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Potassium metabolism in patients with chronic kidney disease. Part II: Patients on dialysis (stage 5)

Musso

2004

Int Urol Nephrol

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Potassium is removed mainly by diffusion during dialysis. In hemodialysis, potassium removal averages 70-150 mmol per session, and the presence of glucose-free dialysate, sodium profiling, and hyperkalemia, may increase its removal. The most frequent potassium derangement in hemodialysis patients is hyperkalemia. Hemofiltration removes approximately 60 mmol of potassium per treatment. In peritoneal dialysis patients, despite lower potassium removal (about 30-40 mmol/day), hypokalemia is the most frequent electrolyte alteration, probably due to movement of potassium into the cells mediated by insulin, secondary to glucose absorption from the dialysis solution.

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“…In dialysis patients, the dialytic procedure assumes the primary role of magnesium removal, therefore the serum magnesium concentration parallels the dialysate magnesium content, which is 0.5-1.5 mEq/l in peritoneal and hemodialysis dialysates whereas it is 0.75-3 mEq/l in hemofiltration substitution solutions [37,38].…”

Section: Dialysismentioning

confidence: 99%

Magnesium metabolism in health and disease

2009

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Magnesium (Mg) is the main intracellular divalent cation, and under basal conditions the small intestine absorbs 30-50% of its intake. Normal serum Mg ranges between 1.7-2.3 mg/dl (0.75-0.95 mmol/l), at any age. Even though eighty percent of serum Mg is filtered at the glomerulus, only 3% of it is finally excreted in the urine. Altered magnesium balance can be found in diabetes mellitus, chronic renal failure, nephrolithiasis, osteoporosis, aplastic osteopathy, and heart and vascular disease. Three physiopathologic mechanisms can induce Mg deficiency: reduced intestinal absorption, increased urinary losses, or intracellular shift of this cation. Intravenous or oral Mg repletion is the main treatment, and potassium-sparing diuretics may also induce renal Mg saving. Because the kidney has a very large capacity for Mg excretion, hypermagnesemia usually occurs in the setting of renal insufficiency and excessive Mg intake. Body excretion of Mg can be enhanced by use of saline diuresis, furosemide, or dialysis depending on the clinical situation.

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Peritoneal dialysis solutions and systems

Cited by 11 publications

References 244 publications

Superiority of Icodextrin Compared with 4.25% Dextrose for Peritoneal Ultrafiltration

Superiority of Icodextrin Compared with 4.25% Dextrose for Peritoneal Ultrafiltration

Potassium metabolism in patients with chronic kidney disease. Part II: Patients on dialysis (stage 5)

Magnesium metabolism in health and disease

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