Long-term use of 1.1% amino acid dialysis solution in hypoalbuminemic continuous ambulatory peritoneal dialysis patients

Taylor, G S; Patel, Vishal; Spencer, S.; Fluck, Richard; McIntyre, Chris

doi:10.5414/cnp58445

Cited by 30 publications

(14 citation statements)

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“…A randomized study over 3 months using 1.1% AA solution showed an anabolic response with increase in IGF and lower phosphorous and potassium levels (63). In another study of 22 CAPD patients with serum albumin levels of less than 3.5 g/dl, use of AA dialysate improved their nutritional status, as measured by an increase in serum albumin levels and net protein catabolic rate (64). A randomized study of 60 patients from China conducted over 3 years and in which half of the patients received one daily exchange of AA-based solution showed that patients receiving AA solution maintained better nutritional parameters, although the survival was similar in both groups (65).…”

Section: Aa Pd Solutionsmentioning

confidence: 99%

Biocompatible Peritoneal Dialysis Solutions

Chaudhary

Khanna

2010

Clinical Journal of the American Society of Nephrology

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Clinical experience and literature evidence suggest that peritoneal dialysis (PD) is a safe and effective treatment in short term (3 to 5 years) for stage 5 chronic kidney disease patients. A major limitation to long-term PD has been peritoneal membrane structural and functional alterations over time, resulting in significant technique failure. Much evidence implicates glucose contained in conventional PD solutions as the major cause of membrane changes. Other harmful characteristics of glucose or its degradation products are thought to cause systemic undesirable metabolic and cardiovascular effects. This led to the search for more "biocompatible" PD solutions to ameliorate complications associated with conventional glucose solutions. Studies in animals and humans show that newer biocompatible solutions may preserve membrane functions better, lead to less therapy failure, and avoid the undesirable metabolic and cardiovascular effects of systemic glucose exposure. There is evidence in specific, clinical, short-term situations of biochemical and metabolic benefits of biocompatible solutions. However, are these solutions superior to glucose in preserving peritoneal membrane long term? Are they truly more biocompatible? Clinical and experimental data suggest that newer solutions, albeit most of them glucose based, are less toxic compared with the current PD solution; however, there is currently no osmotic agent that can safely replace glucose. The future appears to be in using combinations of different osmotic agents in a more biocompatible solution, whether they are mixtures in a single bag or daily exchanges of different osmotic agents. This review discusses the current status of these biocompatible solutions in PD patients.Clin J Am Soc Nephrol 5: 723-732, 2010. doi: 10.2215/CJN.05720809 P eritoneal dialysis (PD) has been an accepted form of renal replacement therapy (RRT) for end-stage renal disease patients (1). Conventional PD solutions contain dextrose as the osmotic agent. Absorbed glucose is metabolized and is used as a source of energy. However, long-term systemic exposure of glucose has been well recognized to cause metabolic and cardiovascular abnormalities, which contribute to some of the morbidities seen in PD patients. PD solutions have a shelf life, and the glucose over time degrades to form glucose degradation products (GDPs), which have been implicated in a variety of adverse effects on the peritoneal membrane, in addition to the well known other systemic effects. Several studies both in vivo and in vitro have shown that conventional solutions damage the mesothelial cells lining the peritoneum, cause peritoneal membrane thickening, and lead to changes of the peritoneal blood vessels (2,3). The dextrose-based solutions have been shown to cause structural as well as functional changes in the peritoneal membrane, which in long-term patients ultimately leads to ultrafiltration failure and discontinuation of PD (4,5). The glucose-based solutions do not contain bicarbonate, which is substituted with the ...

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Section: Aa Pd Solutionsmentioning

confidence: 99%

Biocompatible Peritoneal Dialysis Solutions

Chaudhary

Khanna

2010

Clinical Journal of the American Society of Nephrology

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“…Nutrineal (Baxter, Compton, UK) (1.1% amino acid containing dialysate), a bag designed to improve protein balance, as well as being free from glucose, can be used as a single bag and has shown to improve albumin levels when hypoalbuminemia is present (17). About 18 g of amino acids are absorbed from a single 2-L bag.…”

Section: Nutritional Costs and Benefits Of Peritoneal Dialysismentioning

confidence: 99%

Nutrition in Older Adults on Peritoneal Dialysis

Johansson

2015

Perit Dial Int

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Nutrition in older adults on peritoneal dialysis is an important aspect of a patient's clinical management as well as being influenced by their overall well-being, both mental and physical. This is especially pertinent as individuals age, since the potential impact of life changes and physical changes contribute to the development of protein-energy wasting and potentially exacerbating sarcopenia and wasting. This article provides an outline of the nutritional issues to consider in older adults on peritoneal dialysis (PD). Perit Dial Int

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“…Extraneal, a glucose polymer solution, and Nutrineal, an amino-acid solution, have demonstrated advantages in clinical studies (14,15), but can be administered only once daily. A glucose-free PD regimen based on these new fluids is therefore not feasible.…”

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confidence: 99%

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

et al. 2011

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♦ Background: Glucose and glucose degradation products (GDPs) in peritoneal dialysis fluids (PDFs) are both thought to mediate progressive peritoneal worsening. ♦ Methods: In a multicenter, prospective, randomized crossover study, incident continuous ambulatory peritoneal dialysis patients were treated either with conventional lactate-buffered PDF (sPD regimen) or with a regimen low in glucose and GDPs: Nutrineal×1, Extraneal×1, and Physioneal×2 (NEPP regimen; all solutions: Baxter Healthcare, Utrecht, Netherlands). After 6 months, patients were switched to the alternative regimen for another 6 months. After 6 weeks of run-in, before the switch, and at the end of the study, 4-hour peritoneal equilibration tests were performed, and overnight effluents were analyzed for cells and biomarkers. Differences between the regimens were assessed by multivariate analysis corrected for time and regimen sequence.

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Long-term use of 1.1% amino acid dialysis solution in hypoalbuminemic continuous ambulatory peritoneal dialysis patients

Cited by 30 publications

References 0 publications

Biocompatible Peritoneal Dialysis Solutions

Biocompatible Peritoneal Dialysis Solutions

Nutrition in Older Adults on Peritoneal Dialysis

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

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