Sex-dependent variations in peritoneal membrane transport properties in CAPD patients

Ateş, Kenan; Ertürk, Şehsuvar; Nergisoglu, G.; Karatan, Oktay; Duman, Neval; Erbay, Bülent; Ertug, A. E.

doi:10.1093/oxfordjournals.ndt.a027189

Cited by 7 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The significantly higher proportion of men in the high transporter group is also consistent with previous studies (1,24). In a study of 60 CAPD patients, Ates et al .…”

Section: Discussionsupporting

confidence: 92%

Peritoneal Transport Characteristics, Comorbid Diseases and Survival in CAPD Patients

Chung

Chu²,

Lee³

et al. 2000

Perit Dial Int

View full text Add to dashboard Cite

Objective To evaluate the influence of initial peritoneal transport rate, serum albumin concentration, and comorbid diseases on continuous ambulatory peritoneal dialysis (CAPD) patient survival. Design A prospective single-center study with a long-term follow-up. Patients A total of 213 consecutive CAPD patients, who underwent a peritoneal equilibration test (PET) at a mean of 7 days (range 3 – 30 days) after beginning CAPD, were included in this study. One hundred twenty patients were male, 116 patients had comorbid diseases, and mean age was 49.5 years (range 18 – 76 years). Methods A modified PET was performed using 4.25% glucose dialysis solution. Based on the dialysate-to-plasma creatinine concentration ratio at 4 hours’ dwell (D4/P4 Cr, 0.62 ± 0.14), patients were divided into high (H), high-average (HA), low-average (LA), or low (L) transporters. Results Of 213 patients, 16.9% were classified as H transporters, 30.5% as HA, 36.6% as LA, and 16.0% as L transporters. The H transporter group had a higher proportion of men, higher proportion of patients with comorbid diseases, lower initial serum albumin concentration, lower D4/D0 glucose, and lower drained volume. The initial D4/P4 Cr correlated with initial serum albumin ( r = –0.35, p < 0.001). The patients with comorbid diseases had lower initial serum albumin and higher initial D4/P4 Cr. On Kaplan–Meier analysis, 2-year patient survival of group H was significantly lower compared to the other groups combined (57.1% vs 79.5%, p = 0.009). On Cox proportional hazards analysis, age, comorbid diseases, initial serum albumin concentration, and initial D4/P4 Cr were found to be independent risk factors for mortality. However, in the patients without comorbid diseases, patient survival was not different between group H and the other transport groups combined ( p > 0.05), and only age was found to be an independent risk factor for mortality. Conclusion These data suggest that a high peritoneal transport rate at initial PET is associated with high mortality, and that this is in part due to an increased prevalence of comorbid disease in H transporters. These H transporters with comorbid diseases represent a subset of patients with an especially poor prognosis. In patients without comorbid diseases, high transport status or low serum albumin concentration was not an independent risk factor for mortality.

show abstract

“…The significantly higher proportion of men in the high transporter group is also consistent with previous studies (1,24). In a study of 60 CAPD patients, Ates et al .…”

Section: Discussionsupporting

confidence: 92%

Peritoneal Transport Characteristics, Comorbid Diseases and Survival in CAPD Patients

Chung

Chu²,

Lee³

et al. 2000

Perit Dial Int

View full text Add to dashboard Cite

show abstract

“…Rubin et al, however, demonstrated that there is an imperfect correlation between actual peritoneal surface area and calculated BSA . There may also be sex differences in peritoneal surface areas, which, in turn, affect absorption characteristics . BSA‐based IP chemotherapy will result in a fixed dose diluted in varying volumes of perfusate; that is, different concentrations depending on substantial differences in the body composition of patients and differences in the HIPEC technique.…”

Section: Introductionmentioning

confidence: 99%

“…10 There may also be sex differences in peritoneal surface areas, which, in turn, affect absorption characteristics. 11 BSA-based IP chemotherapy will result in a fixed dose diluted in varying volumes of perfusate; that is, different concentrations depending on substantial differences in the body composition of patients and differences in the HIPEC technique. From the Dedrick formula we know that peritoneal concentration and not peritoneal dose is the driving diffusion force.…”

mentioning

confidence: 99%

Body surface area‐based vs concentration‐based perioperative intraperitoneal chemotherapy after optimal cytoreductive surgery in colorectal peritoneal surface malignancy treatment: COBOX trial

Lemoine

Thijssen

Carleer

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background and Objectives Cytoreductive surgery (CRS) and hyperthermic intraperitoneal perioperative chemotherapy (HIPEC) are the standard of care for patients diagnosed with colorectal peritoneal surface malignancy (PSM). Despite a clearly defined standardization of CRS, a large variety of HIPEC modalities are still used in clinical practice. Methods Body surface area (BSA)‐ and concentration‐based HIPEC protocols were clinically and pharmacologically evaluated in a randomized phase III clinical pilot trial. Oxaliplatin dose was 460 mg/m 2 (BSA‐based) in 2 L/m 2 carrier solution (concentration‐based). Platinum quantification was performed using a validated inductively coupled plasma mass spectrometry method. Three‐month morbidity, mortality, and health‐related quality of life (HRQOL) were assessed. Results Thirty‐one patients were randomized to either BSA‐ or concentration‐based HIPEC. Toxicity and efficacy were higher (P < 0.001) in patients receiving concentration‐based HIPEC. There was no difference in pharmacologic advantage between the two groups. A higher drug concentration in the tumor nodule at the end of HIPEC was found in the HIPEC‐concentration group. There was no difference in major morbidity and mortality between the treatment groups. HRQOL was decreased 3 months postoperatively in the HIPEC‐concentration group. Conclusion Concentration‐based chemotherapy delivers the drug in the most standardized way to the tumor nodule, resulting in increasing drug concentrations in the tumor nodule without increasing major morbidity.

show abstract

“…however, demonstrated there is an imperfect correlation between actual peritoneal surface area and calculated BSA [9, 10]. There may also be sex differences in peritoneal surface areas, which in turn affects absorption characteristics [11]. As a result, BSA-based IP chemotherapy will deliver a fixed dose (BSA-based) diluted in varying volumes of perfusate; i.e.…”

Section: Introductionmentioning

confidence: 99%

Body surface area-based versus concentration-based intraperitoneal perioperative chemotherapy in a rat model of colorectal peritoneal surface malignancy: pharmacologic guidance towards standardization

et al. 2019

View full text Add to dashboard Cite

Worldwide, cytoreductive surgery (CRS) and hyperthermic intraperitoneal perioperative chemotherapy (HIPEC) are used in current clinical practice for colorectal peritoneal surface malignancy (PSM) treatment. Although, there is an acknowledged standardization regarding the CRS, we are still lacking a much-needed standardization amongst the various intraperitoneal (IP) chemotherapy protocols, including the HIPEC dosing regimen. We should rely on pharmacologic evidence building towards such a standardization. The current IP chemotherapy dosing regimens can be divided into body surface area (BSA)-based and concentration-based protocols. A preclinical animal study was designed to evaluate pharmacologic advantage (PA), efficacy and survival. WAG/Rij rats were IP injected with the rat colonic carcinoma cell line CC-531. Animals were randomized into three groups: CRS alone or CRS combined with oxaliplatin-based HIPEC (either BSA- or concentration-based). There was no difference in PA between the two groups (p=0.283). Platinum concentration in the tumor nodule was significantly higher in the concentration-based group ( p <0.001). Median survival did not differ between the treatment groups ( p <0.250). This preclinical study, in contrast to previous thinking, clearly demonstrates that the PA does not provide any information about the true efficacy of the drug and emphasizes the importance of the tumor nodule as pharmacologic endpoint.

show abstract

Sex-dependent variations in peritoneal membrane transport properties in CAPD patients

Cited by 7 publications

References 0 publications

Peritoneal Transport Characteristics, Comorbid Diseases and Survival in CAPD Patients

Peritoneal Transport Characteristics, Comorbid Diseases and Survival in CAPD Patients

Body surface area‐based vs concentration‐based perioperative intraperitoneal chemotherapy after optimal cytoreductive surgery in colorectal peritoneal surface malignancy treatment: COBOX trial

Body surface area-based versus concentration-based intraperitoneal perioperative chemotherapy in a rat model of colorectal peritoneal surface malignancy: pharmacologic guidance towards standardization

Contact Info

Product

Resources

About