Effect of Peritoneal Dialysis Solution Type on Serum Lipid Levels in End-Stage Renal Disease

Abstract

Among the different cardiovascular risk factors, lipid abnormalities dominate the high mortality in chronic ambulatory peritoneal dialysis patients. So far, no data comparing the effect of standard glucose-containing, amino acid-containing, and icodextrin-containing peritoneal dialysis solutions on serum lipid concentrations in a chronic ambulatory peritoneal dialysis population are available. To determine the effect of peritoneal dialysis solutions on parameters of lipid metabolism, 67 subjects who had continued their usual dialysis for the last six months were enrolled in the study. Group A consisted of 18 patients who were receiving only glucosebased peritoneal dialysis solutions, group B consisted of 18 patients who were receiving glucose and amino acid-based peritoneal dialysis solutions, and group C consisted of 31 patients who were receiving glucose and icodextrin-based peritoneal dialysis solutions. Serum lipid parameters including total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride, and lipoprotein (a) were determined in all groups. No significant difference in serum lipid parameters was found between groups A, B, and C. These results demonstrate the lack of the effect of amino acid or icodextrin-based peritoneal solutions on dyslipidemia of CAPD patients.

Comparison of Intraperitoneal Amino Acid and Oral Amino Acid Supplements in Peritoneal Dialysis Patients

“…In their study, Kanbay et al found that serum lipid parameters of solutions with AAs and other solutions administered during peritoneal dialysis did not differ significantly [51]. Contrary to expectations, the current study detected significant decrease in HDL levels of the Nutrineal group, with cholesterol values remaining stable.…”

Two daytime icodextrin exchanges decrease brain natriuretic peptide levels and improve cardiac functions in continuous ambulatory peritoneal dialysis patients

“…It is known that long‐term icodextrin usage has no harmful influence on the peritoneal membrane 32 . Gobin et al.…”

Complications of Peritoneal Dialysis Part II

“…96 Clinical trials with amino acid-based dialysate have shown mixed results with respect to plasma lipid levels. [97][98][99] The Improved Metabolic Control of Physioneal, Extraneal and Nutrineal (IM-PENDA) and Evaluation of Dianeal, Extraneal and Nutrineal in diabetic PD patients (EDEN) studies demonstrated that PD prescriptions containing amino acid-based dialysate and icodextrin achieved lower serum lipid levels when compared with dextrose-only PD prescriptions. However, the amino acids and icodextrin group also demonstrated higher mortality from congestive heart failure.…”