Biocompatibility and New Fluids

Coles, Gerald A.

doi:10.1177/089686089901902s44

Cited by 14 publications

(9 citation statements)

References 27 publications

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“…8,23 Most of these bioincompatible effects appear to be due to the acidic pH and high concentrations of GDPs of the standard solutions following heat sterilization or periods of extended storage. 16,17,[24][25][26][27][28] Sterilization of glucose-containing PD solutions in buffer at a pH of 5.5, which is typical for conventional standard solutions, unfortunately is far from optimal and leads to a signifi cant amount of GDPs. 29,30 Data suggest that the acidic pH that is a feature of all conventional and some new solutions has toxic effects.…”

Section: Safety and Effi Cacymentioning

confidence: 99%

PD solutions: New and old

Díaz-Buxó

Sawin

Himmele

2011

Dialysis & Transplantation

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Peritoneal dialysis (PD) solutions have evolved since Boen described the appropriate composition of a suitable fluid comprising an osmotic agent, electrolytes, and buffer substance in 1969. New solutions introducing alternative osmotic agents and bicarbonate as an alternative to lactate‐buffered solutions have been developed. These so‐called biocompatible solutions belong to a very heterogeneous group of PD fluids that share some features but are distinct in other aspects. All biocompatible solutions have a substantially reduced level of toxic glucose degradation products (GDPs). However, the new solutions differ in their absolute GDP content, osmotic agent, buffer substance, and pH. The differences from the conventional solutions and the characteristics of the distinct new solutions are presented in this review together with a discussion of their potential clinical benefits and implications. Dial. Transplant. © 2011 Wiley Periodicals, Inc.

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Section: Safety and Effi Cacymentioning

confidence: 99%

PD solutions: New and old

Díaz-Buxó

Sawin

Himmele

2011

Dialysis & Transplantation

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“…This did not meaningfully change the estimates or results above (analyses not shown). [23][24][25][26][27]. Focusing on 3,4-DGE, the lowest concentration of this GDP will occur during heat sterilization of a glucose containing solution at a pH of between 2 and 3 [28][29][30].…”

Section: Resultsmentioning

confidence: 99%

Biocompatibility of a new PD solution for Japan, Reguneal™, measured as in vitro proliferation of fibroblasts

et al. 2018

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“…The routine use of conventional glucose-based solutions in PD has been linked to a number of adverse metabolic consequences of systemic glucose absorption, including hyperglycaemia, hyperinsulinaemia, hyperlipidaemia, obesity, suppressed appetite and altered food preference. [9][10][11]25 As icodextrin is a solution containing a spectrum of high molecular weight polysaccharides (average molecular weight 16 200 Da) that are slowly absorbed across the peritoneal membrane, it has been suggested that certain patient groups such as diabetics may benefit from the use of such a non-glucose solution. In the MIDAS study, 13 total carbohydrate absorption during an 8-h dwell was measured in seven controls (six on 3.86% and one on 2.27%), and 11 icodextrin-treated patients.…”

Section: Icodextrin Use In Patients With Diabetes Mellitusmentioning

confidence: 99%

Recommendations for the use of icodextrin in peritoneal dialysis patients

Johnson¹,

Agar

Collins

et al. 2003

Nephrology

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SUMMARY:Icodextrin is a starch-derived, high molecular weight glucose polymer, which has been shown to promote sustained ultrafiltration equivalent to that achieved with hypertonic (3.86%/4.25%) glucose exchanges during prolonged intraperitoneal dwells (up to 16 h). Patients with impaired ultrafiltration, particularly in the settings of acute peritonitis, high transporter status and diabetes mellitus, appear to derive the greatest benefit from icodextrin with respect to augmentation of dialytic fluid removal, amelioration of symptomatic fluid retention and possible prolongation of technique survival. Glycaemic control is also improved by substituting icodextrin for hypertonic glucose exchanges in diabetic patients. Preliminary in vitro and ex vivo studies suggest that icodextrin demonstrates greater peritoneal membrane biocompatibility than glucose-based dialysates, but these findings need to be confirmed by long-term clinical studies. This paper reviews the available clinical evidence pertaining to the safety and efficacy of icodextrin and makes recommendations for its use in peritonal dialysis.

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Biocompatibility and New Fluids

Cited by 14 publications

References 27 publications

PD solutions: New and old

PD solutions: New and old

Biocompatibility of a new PD solution for Japan, Reguneal™, measured as in vitro proliferation of fibroblasts

Recommendations for the use of icodextrin in peritoneal dialysis patients

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