Bicarbonate/lactate-based peritoneal dialysis solution increases cancer antigen 125 and decreases hyaluronic acid levels

Abstract

These results suggest that continuous therapy with the B/L solutions modulates the levels of putative markers of peritoneal membrane integrity and inflammation. In the long term, this may positively impact the peritoneal membrane, increasing its life as a dialyzing organ.

Impact of a Low-Glucose Peritoneal Dialysis Regimen on Fibrosis and Inflammation Biomarkers

“…35, NO. 2 PDI than conventional PD in preserving mesothelial cell mass, which is in keeping with independent studies that utilize different biocompatible regimens (9,10,29). Cancer antigen 125 levels decreased by approximately 40% when PEN patients were switched to glucose-based PDF but statistically remained significantly higher than controls, suggesting that the beneficial effect of PEN can be sustained after patients change to a less biocompatible regimen.…”

A Peritoneal Dialysis Regimen Low in Glucose and Glucose Degradation Products Results in Increased Cancer Antigen 125 and Peritoneal Activation

“…Activation of the peritoneum is also highly suggested because of increased cell numbers; increased chemokines, cytokines, and growth factors; and increased peritoneal transport. Other authors have compared new multi-chamber lactate or bicarbonate/lactate solutions with conventional PD solutions (8)(9)(10)12). Those studies showed increased levels of CA125, suggesting increased MC mass, or regeneration, or both.…”

“…The main goal of these developments is to preserve the capacity of the peritoneal membrane for PD. In clinical studies, use of new glucose-based solutions with low GDPs and a neutral pH is associated with increased effluent levels of cancer antigen 125 (CA125) (8)(9)(10), which is used as indicator for MC mass (11). Higher CA125 levels suggest regeneration of the MC layer (12).…”

Biocompatible Solutions for Peritoneal Dialysis

“…More biocompatibility suggests that these solutions should be the choice if there are resources to pay for them. Their use has resulted in improvement in surrogate parameters in clinical trials and observational studies including a higher peritoneal effluent concentration of CA125 (considered by many as a marker of mesothelial mass), lower rate of apoptosis in the effluent, lower concentration of circulating AGEs, better control of metabolic acidosis, better preservation of residual renal function, lower incidence of peritonitis, and in Registry studies, lower mortality (Table 4) (Montenegro, J. et al 2007;Montenegro, J. et al 2006;Williams, J. D. et al 2004;Kim, S. G. et al 2008;Lee, H. Y. et al 2005;Navarro, J. F. et al 1999;Rippe, B. et al 2001;Fan, S. L. et al 2008;Ahmad, S. et al 2006;Carrasco, A. M. et al 2001;Fusshoeller, A. et al 2004;Jones, S. et al 2001;Haas, S. et al 2003). As indicated above, the different characteristics of the various commercially available biocompatible solutions do not allow concluding that the observed effects are class effects.…”

“…Surrogate markers Increased CA125 biomarker in the peritoneal effluent (Williams, J. D. et al 2004;Fusshoeller, A. et al 2004;Jones, S. et al 2001;Haas, S. et al 2003;Rippe, B. et al 2001) Lower circulating AGEs (Fusshoeller, A. et al 2004;Williams, J. D. et al 2004) Better correction of acidosis (Montenegro, J. et al 2006;Tranaeus, A.2000;Otte, K. et al 2003;Carrasco, A. M. et al 2001;Haas, S. et al 2003) Better preserved residual renal function (Montenegro, J. et al 2007;Williams, J. D. et al 2004;Kim, S. G. et al 2008) No change (Fan, S. L. et al 2008 Rippe, B. et al 2001) 1 No clinical trials have been published whose primary objective is the study of these items Table 4. Beneficial effects of new glucose solutions in clinical practice…”