Polyglucose and Amino Acids: Preliminary Results

Faller, B; Shockley, Ty R.; Genestier, Sandrine; Martis, Leo

doi:10.1177/089686089701702s12

Cited by 19 publications

(14 citation statements)

References 13 publications

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“…These results are in line with mathematical modeling both in mice and in patients, 25 and data from clinical studies. [49][50][51][52][53] The use of combined solutions led to a fast, glucose-induced, and AQP1-dependent osmotic water transport during the first part of the dwell, and a sustained UF thanks to the presence of large, colloidal fractions of icodextrin. Importantly, these large fractions enhanced solute-coupled water removal and prevented the backflow of water from dialysate to peritoneal capillaries after the dissipation of crystalloid osmotic gradient.…”

Section: Discussionmentioning

confidence: 99%

Mechanisms of Crystalloid versus Colloid Osmosis across the Peritoneal Membrane

Morelle

Sow

Fustin

et al. 2018

JASN

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Osmosis drives transcapillary ultrafiltration and water removal in patients treated with peritoneal dialysis. Crystalloid osmosis, typically induced by glucose, relies on dialysate tonicity and occurs through endothelial aquaporin-1 water channels and interendothelial clefts. In contrast, the mechanisms mediating water flow driven by colloidal agents, such as icodextrin, and combinations of osmotic agents have not been evaluated. We used experimental models of peritoneal dialysis in mouse and biophysical studies combined with mathematical modeling to evaluate the mechanisms of colloid versus crystalloid osmosis across the peritoneal membrane and to investigate the pathways mediating water flow generated by the glucose polymer icodextrin. modeling and studies showed that deletion of aquaporin-1 did not influence osmotic water transport induced by icodextrin but did affect that induced by crystalloid agents. Water flow induced by icodextrin was dependent upon the presence of large, colloidal fractions, with a reflection coefficient close to unity, a low diffusion capacity, and a minimal effect on dialysate osmolality. Combining crystalloid and colloid osmotic agents in the same dialysis solution strikingly enhanced water and sodium transport across the peritoneal membrane, improving ultrafiltration efficiency over that obtained with either type of agent alone. These data cast light on the molecular mechanisms involved in colloid versus crystalloid osmosis and characterize novel osmotic agents. Dialysis solutions combining crystalloid and colloid particles may help restore fluid balance in patients treated with peritoneal dialysis.

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Section: Discussionmentioning

confidence: 99%

Mechanisms of Crystalloid versus Colloid Osmosis across the Peritoneal Membrane

Morelle

Sow

Fustin

et al. 2018

JASN

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show abstract

“…Preliminary results in humans using a 0.6% amino acid and 1.4% glycerol mixture showed equal solute and fluid transport but a reduced caloric uptake (71). A mixture of 4% polyglucose and 1% amino acids resulted in a similar ultrafiltration volume as a 3.86% glucose solution after a 10 hr dwell (72). This solution resulted in lower polyglucose and maltose levels compared to 7.5% polyglucose.…”

Section: Mixtures Of Solutesmentioning

confidence: 93%

Future Research in Peritoneal Dialysis Fluids

Struijk

Douma

1998

Seminars in Dialysis

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“…In a study of 20 patients, a baseline phase using 3.86% glucose for the overnight exchange was compared with 4-week periods of icodextrin 7.5% and a mixture of amino acid 1% with icodextrin 4%. After a 10-hour overnight dwell, UF volumes were not different between the three types of solutions; however, the UF profiles demonstrated the amino acid 1%/icodextrin 4% mixture lay between the 3.86% glucose and the 7.5% icodextrin curves, having some of the early rapid increase in intraperitoneal volume seen with crystalloid osmosis (12) (Figure 1). In a 3-month study using a mixture of 0.6% amino acids and 1.4% glycerol (13), patients received 2 x 2-L exchanges of the amino acid/glycerol solution, 1 x 2 L icodextrin, and at least 1 x 2 L of a classic glucose solution.…”

Section: Background To the Use Of Combination Solutionsmentioning

confidence: 99%