2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by DAVIES, S. J. Articles by RUSSELL, G. I. Search for Related Content PubMed PubMed Citation Articles by DAVIES, S. J. Articles by RUSSELL, G. I.

Peritoneal Glucose Exposure and Changes in Membrane Solute Transport with Time on Peritoneal Dialysis

Department of Nephrology, North Staffordshire Hospitals Trust, Stoke-on-Trent, United Kingdom.

Correspondence to Dr. Simon J. Davies, Department of Nephrology, North Staffordshire Hospitals Trust, Princes Road, Hartshill, Stoke-on-Trent, ST4 7LN, UK. Phone: 01782-554164; Fax: 01782-620759; E-mail: SimonDavies1{at}compuserve.com

Abstract. Peritoneal solute transport increases with time on treatment in a proportion of peritoneal dialysis (PD) patients, contributing to ultrafiltration failure. Continuous exposure of the peritoneum to hypertonic glucose solutions results in morphologic damage that may have a causative role in changes in peritoneal function. The purpose of this analysis was to establish whether increased exposure to glucose preceded changes in solute transport in a selected group of long-term PD patients. Peritoneal solute transport, residual renal function, peritonitis rate, and peritoneal exposure to glucose were recorded prospectively in a cohort of 303 patients at a single dialysis center. A subgroup of individuals, treated continuously for 5 yr, were identified and defined retrospectively as having either stable or increasing transport status. Of the 22 patients who were treated continuously for 5 yr, 13 had stable solute transport (solute transport at start, 0.67 [±0.1]; at 5 yr, 0.67 [±0.1]), whereas 9 had a sustained increase (solute transport at start, 0.56 [±0.08]; at 5 yr, 0.77 [±0.09]). Compared with the stable patients, those with increasing transport had earlier loss in residual renal function and were exposed to significantly more hypertonic glucose during the first 2 yr of treatment that preceded the increase in solute transport. This was associated with greater achieved ultrafiltration compensating for the reduced urinary volumes in these patients. Further increases in glucose exposure were observed as solute transport continued to rise. Peritonitis, including severity of infection and causative organism, was similar in both groups. In this selected group of long-term survivors on PD, an increase in solute transport with time was preceded by increased peritoneal exposure to hypertonic glucose. This is supportive evidence that hypertonic glucose may play a causative role in alterations in peritoneal membrane function.

This article has been cited by other articles:

				K. Kaifu, H. Kiyomoto, H. Hitomi, K. Matsubara, T. Hara, K. Moriwaki, G. Ihara, Y. Fujita, N. Sugasawa, D. Nagata, et al. Insulin attenuates apoptosis induced by high glucose via the PI3-kinase/Akt pathway in rat peritoneal mesothelial cells Nephrol. Dial. Transplant., October 30, 2008; (2008) gfn598v1. [Abstract] [Full Text] [PDF]

				A. M. Coester, M. M. Zweers, D. R. de Waart, and R. T. Krediet The relationship between effluent potassium due to cellular release, free water transport and CA125 in peritoneal dialysis patients NDT Plus, October 1, 2008; 1(suppl_4): iv41 - iv45. [Abstract] [Full Text] [PDF]

				R. T. Krediet, M. M. Zweers, R. van Westrhenen, A. Zegwaard, and D. G. Struijk Effects of reducing the lactate and glucose content of PD solutions on the peritoneum. Is the future GLAD? NDT Plus, October 1, 2008; 1(suppl_4): iv56 - iv62. [Abstract] [Full Text] [PDF]

				K.-H. Oh, J.-Y. Moon, J. Oh, S. G. Kim, Y.-H. Hwang, S. Kim, J. S. Lee, and C. Ahn Baseline peritoneal solute transport rate is not associated with markers of systemic inflammation or comorbidity in incident Korean peritoneal dialysis patients Nephrol. Dial. Transplant., July 1, 2008; 23(7): 2356 - 2364. [Abstract] [Full Text] [PDF]

				N. M. Selby, J. Fialova, J. O. Burton, and C. W. McIntyre The haemodynamic and metabolic effects of hypertonic-glucose and amino-acid-based peritoneal dialysis fluids Nephrol. Dial. Transplant., March 1, 2007; 22(3): 870 - 879. [Abstract] [Full Text] [PDF]

				C.-C. Szeto, K.-M. Chow, C. W.-K. Lam, C.-B. Leung, B. C.-H. Kwan, K.-Y. Chung, M.-C. Law, and P. K.-T. Li Clinical biocompatibility of a neutral peritoneal dialysis solution with minimal glucose-degradation products--A 1-year randomized control trial Nephrol. Dial. Transplant., February 1, 2007; 22(2): 552 - 559. [Abstract] [Full Text] [PDF]

				S.-K. Shin, C. D. Kamerath, J. F. Gilson, and J. K. Leypoldt Effects of anaesthesia on fluid and solute transport in a C57BL6 mouse model of peritoneal dialysis Nephrol. Dial. Transplant., October 1, 2006; 21(10): 2874 - 2880. [Abstract] [Full Text] [PDF]

				G. Clerbaux, J. Francart, P. Wallemacq, A. Robert, and E. Goffin Evaluation of peritoneal transport properties at onset of peritoneal dialysis and longitudinal follow-up Nephrol. Dial. Transplant., April 1, 2006; 21(4): 1032 - 1039. [Abstract] [Full Text] [PDF]

				A. S. Rodrigues, M. Almeida, I. Fonseca, M. Martins, M. J. Carvalho, F. Silva, C. Correia, M. J. Santos, and A. Cabrita Peritoneal fast transport in incident peritoneal dialysis patients is not consistently associated with systemic inflammation Nephrol. Dial. Transplant., March 1, 2006; 21(3): 763 - 769. [Abstract] [Full Text] [PDF]

				M. Zareie, E. D. Keuning, P. M. ter Wee, C. G. Schalkwijk, R. H. J. Beelen, and J. van den Born Improved biocompatibility of bicarbonate/lactate-buffered PDF is not related to pH Nephrol. Dial. Transplant., January 1, 2006; 21(1): 208 - 216. [Abstract] [Full Text] [PDF]

				M. Zareie, G.-J. Tangelder, P. M. ter Wee, L. H. Hekking, A. A. van Lambalgen, E. D. Keuning, I. L. Schadee-Eestermans, C. G. Schalkwijk, R. H. Beelen, and J. van den Born Beneficial effects of aminoguanidine on peritoneal microcirculation and tissue remodelling in a rat model of PD Nephrol. Dial. Transplant., December 1, 2005; 20(12): 2783 - 2792. [Abstract] [Full Text] [PDF]

				N. M. Selby, S. Fonseca, L. Hulme, R. J. Fluck, M. W. Taal, and C. W. McIntyre Hypertonic glucose-based peritoneal dialysate is associated with higher blood pressure and adverse haemodynamics as compared with icodextrin Nephrol. Dial. Transplant., September 1, 2005; 20(9): 1848 - 1853. [Abstract] [Full Text] [PDF]

				G. del Peso, M. J. Fernandez-Reyes, C. Hevia, M. A. Bajo, M. J. Castro, A. Cirugeda, J. A. Sanchez-Tomero, and R. Selgas Factors influencing peritoneal transport parameters during the first year on peritoneal dialysis: peritonitis is the main factor Nephrol. Dial. Transplant., June 1, 2005; 20(6): 1201 - 1206. [Abstract] [Full Text] [PDF]

				L. Nanovic Electrolytes and Fluid Management in Hemodialysis and Peritoneal Dialysis Nutr Clin Pract, April 1, 2005; 20(2): 192 - 201. [Abstract] [Full Text] [PDF]

				M. F. Flessner The transport barrier in intraperitoneal therapy Am J Physiol Renal Physiol, March 1, 2005; 288(3): F433 - F442. [Abstract] [Full Text] [PDF]

				M. Zareie, E. D. Keuning, P. M. ter Wee, R. H. J. Beelen, and J. van den Born Peritoneal dialysis fluid-induced changes of the peritoneal membrane are reversible after peritoneal rest in rats Nephrol. Dial. Transplant., January 1, 2005; 20(1): 189 - 193. [Abstract] [Full Text] [PDF]

				F. Termorshuizen, J. C. Korevaar, F. W. Dekker, J. G. van Manen, E. W. Boeschoten, and R. T. Krediet Hemodialysis and Peritoneal Dialysis: Comparison of Adjusted Mortality Rates According to the Duration of Dialysis: Analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis 2 J. Am. Soc. Nephrol., November 1, 2003; 14(11): 2851 - 2860. [Abstract] [Full Text] [PDF]

				E. A. Brown, S. J. Davies, P. Rutherford, F. Meeus, M. Borras, W. Riegel, J. C. Divino Filho, E. Vonesh, and M. Van Bree Survival of Functionally Anuric Patients on Automated Peritoneal Dialysis: The European APD Outcome Study J. Am. Soc. Nephrol., November 1, 2003; 14(11): 2948 - 2957. [Abstract] [Full Text] [PDF]

				S. Haas, C. P. Schmitt, K. Arbeiter, K.-E. Bonzel, M. Fischbach, U. John, A.-K. Pieper, T. P. Schaub, J. Passlick-Deetjen, O. Mehls, et al. Improved Acidosis Correction and Recovery of Mesothelial Cell Mass with Neutral-pH Bicarbonate Dialysis Solution among Children Undergoing Automated Peritoneal Dialysis J. Am. Soc. Nephrol., October 1, 2003; 14(10): 2632 - 2638. [Abstract] [Full Text] [PDF]

				S. J. Davies, G. Woodrow, K. Donovan, J. Plum, P. Williams, A. C. Johansson, H.-P. Bosselmann, O. Heimburger, O. Simonsen, A. Davenport, et al. Icodextrin Improves the Fluid Status of Peritoneal Dialysis Patients: Results of a Double-Blind Randomized Controlled Trial J. Am. Soc. Nephrol., September 1, 2003; 14(9): 2338 - 2344. [Abstract] [Full Text] [PDF]

				W. Van Biesen, O. Carlsson, R. Bergia, M. Brauner, A. Christensson, S. Genestier, M. Haag-Weber, J. Heaf, P. Joffe, A.-C. Johansson, et al. Personal dialysis capacity (PDCTM) test: a multicentre clinical study Nephrol. Dial. Transplant., April 1, 2003; 18(4): 788 - 796. [Abstract] [Full Text] [PDF]

				P. J. Margetts and D. N. Churchill Acquired Ultrafiltration Dysfunction in Peritoneal Dialysis Patients J. Am. Soc. Nephrol., November 1, 2002; 13(11): 2787 - 2794. [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673