Do We Have a Biocompatible Peritoneal Dialysis Fluid?

Abstract

Objective: Cardiovascular disease remains the leading cause of morbidity and mortality in patients on maintenance dialysis. Diabetes mellitus, dyslipidemia, hypertension, inflammation and hyperhomocyteinemia are major cardiovascular risk factors. Aim: to evaluate the effects of Icodextrin and amino acid peritoneal dialysis fluid (AAPDF) on these major cardiovascular risk factors looking for a more biocompatible PDF formula. Methods: 24 adult stable peritoneal dialysis patients were included in the study. 12 patients received 2L Icodextrin and other 12 patients received 2L AAPDF in their dialysis prescription for 8 weeks. Results: Icodextrin decreased fasting plasma glucose (p < 0.001), LDL-C (p = 0.03), SBP (p < 0.01), DBP (p < 0.05) and plasma homocysteine (p = 0.002), and increased HDL-C (p = 0.009), CRP (p = 0.035) and fibrinogen (p = 0.009). AAPDF did not affect fasting plasma glucose, LDL-C, HDL-C, CRP and fibrinogen but increased serum albumin (p = 0.03), SBP (p < 0.01), DBP (p < 0.05) and PHcy (p = 0.03). Conclusions: A biocompatible PDF should provide not only adequate dialysis and ultrafiltration but should also improve nutritional and metabolic status, blood pressure control and reduce inflammation and plasma homocyteine.

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S. Hassan, B. Kristal, K. Khazim, F. Hassan, D. Hassan and K. Hassan, "Do We Have a Biocompatible Peritoneal Dialysis Fluid?," Open Journal of Nephrology, Vol. 2 No. 3, 2012, pp. 29-34. doi: 10.4236/ojneph.2012.23005.

Conflicts of Interest

The authors declare no conflicts of interest.

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