The Trio Trial – a Randomized Controlled Clinical Trial Evaluating the Effect of a Biocompatible Peritoneal Dialysis Solution on Residual Renal Function

Sikaneta, Tabo; Wu, George; Abdolell, Mohamed; Ng, Anita; Mahdavi, Sara; Svendrovski, Anton; Tu, Tony; Mercer, T.M.; Tong, Macy; Oreopoulos, Dimitrios G.; Tam, Paul

doi:10.3747/pdi.2015.00090

Cited by 26 publications

(23 citation statements)

References 14 publications

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“…Modifying the peritoneal dialysate by raising pH, reducing glucose, and using non-lactate fluids as a buffer was thought to lessen the adverse effects of conventional PD solutions. Previous small, randomized controlled trials (RCTs) have demonstrated conflicting results with respect to the effects of biocompatible PD solutions on RRF decline in PD patients compared with conventional PD solutions [68][69][70][71][72] . Yohanna et al 73 systematically reviewed 11 trials in which 643 patients were included.…”

Section: Preservation Of Rrfmentioning

confidence: 99%

Current guidelines in peritoneal dialysis – Part II

Ferreira

Borges

Abreu

et al. 2019

pjnh

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Section: Preservation Of Rrfmentioning

confidence: 99%

Current guidelines in peritoneal dialysis – Part II

Ferreira

Borges

Abreu

et al. 2019

pjnh

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“…Most recently, the TRIO trial, designed to verify the results of balANZ, randomized 67 incident dialysis patients from two centers in Canada and one in Hong Kong to the lactate‐buffered NpHLGDP Gambrosol Trio (Gambro Lundia AB, Lund, Sweden), or conventional PD solutions, and chose as primary outcome slope of decline of RKF . Significantly lower rates in the decline of RKF and urine output were observed with NpHLGDP solution (decline of 0.132 vs. 0.174 ml/minute/1.73 m 2 /month with Gambrosol Trio and conventional PD solution, respectively, p = 0.001), concordant with the findings of previous studies.…”

Section: Clinical Outcomesmentioning

confidence: 99%

“Biocompatible” Neutral pH Low‐GDP Peritoneal Dialysis Solutions: Much Ado About Nothing?

Misra

Nessim

Perl

2017

Seminars in Dialysis

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Adverse outcomes in peritoneal dialysis (PD), including PD related infections, the loss of residual kidney function (RKF), and longitudinal, deleterious changes in peritoneal membrane function continue to limit the long-term success of PD therapy. The observation that these deleterious changes occur upon exposure to conventional glucose-based PD solutions fuels the search for a more biocompatible PD solution. The development of a novel PD solution with a neutral pH, and lower in glucose degradation products (GDPs) compared to its conventional predecessors has been labeled a "biocompatible" solution. While considerable evidence in support of these novel solutions' biocompatibility has emerged from cell culture and animal studies, the clinical benefits as compared to conventional PD solutions are less clear. Neutral pH low GDP (NpHLGDP) PD solutions appear to be effective in reducing infusion pain, but their effects on other clinical endpoints including peritoneal membrane function, preservation of RKF, PD-related infections, and technique and patient survival are less clear. The literature is limited by studies characterized by relatively few patients, short follow-up time, heterogeneity with regards to the novel PD solution type under study, and the different patient populations under study. Nonetheless, the search for a more biocompatible PD solution continues with emerging data on promising non glucose-based solutions.

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“…A Gambrosol Trio biokompatibilis PD-oldattal kétéves követés során -a konvencionális Dianeal oldatokkal kezelt csoporttal összevetve -kisebbnek találták [19] a residualis GFR csökkenésének ütemét (0,132 ml/perc/1,73 m 2 /hónap 51 biokompatibilis ágon szereplő és 0,174 ml/perc/1,73 m 2 /hónap a standard hagyományos ágon lévő 50 beteg esetében; p = 0,001).…”

Section: Biokompatibilis Peritonealis Dializálóoldatokunclassified

Glükózterhelés a peritonealis dialízisben. Újabb elméleti megfontolások

Mácsai¹,

Kiss

2017

Orvosi Hetilap

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A peritonealis dialízis jelentősége a vesepótló kezelésben várhatóan növekedni fog, emiatt különösen fontos a peritonealis dialízis technológiájának legfőbb hátrányát jelentő glükózexpozíció újragondolása, az adverz hatások minimá-lisra csökkentése, amely a PD-oldatok további fejlesztésétől várható. Az első lépést a jelenlegi konvencionális glü-kózalapú PD-oldatok lokális és szisztémás káros hatásainak csökkentésében a biokompatibilis és nem glükózalapú modern PD-oldatok kifejlesztése jelentette. Egyelőre -limitált tapasztalatok alapján -nincsenek egyértelmű adatok a jobb klinikai kimenetelre. Felmerül az elméleti összefüggés a PD ritka szövődményeként kialakuló enkapszuláló peritonealis sclerosis és a peritonealis felszín lokális tartós glükózirritációja között. A szisztémás glykaemiás terhelés mértéke az aktuális állapotot tükröző szövetiglükóz-monitorozással, a hosszabb távon kialakuló kumulatív károsodás a bőr-autofluoreszcencia mérése útján követhető, a klinikai gyakorlatban azonban egyelőre egyik módszer sem kiterjedten használt. A modalitásból eredően fokozottabb a cardiovascularis betegségek rizikója, ezek mielőbbi diagnosztikája és kezelése kiemelt fontosságú. A diabetológiai szempontokat is tekintetbe vevő terápiás lépések megválasztá-sakor a páciensek életminőségi mutatóinak javítására, a megvalósítható legoptimálisabb életvitelre kell törekednünk. Orv Hetil. 2017; 158(43): 1708-1714.Kulcsszavak: peritonealis dializálóoldatok, biokompatibilitás, bőr-autofluoreszcencia, peritonealis remodelling, glykaemiás terhelés Re-engineering of glucose exposure in peritoneal dialysisThe significance of peritoneal dialysis in kidney replacement therapy is expected to increase, so it is important to reconsider glucose exposure to minimize the adverse effects. The first step was to develop biocompatible modern PD solutions to reduce the local and systemic adverse effects of current conventional glucose-based ones. According to the limited clinical experience, there are no clear data on better clinical outcome. Besides this there is a suspected theoretical correlation between development of encapsulating peritoneal sclerosis and chronic local irritation of peritoneal surface by glucose. The degree of actual systemic glycemic load can be evaluated by continuous tissue glucose monitoring, and cumulative damage can be measured by skin autofluorescence, however none of the methods have been extensively used in clinical practice. The early diagnosis of cardiovascular diseases is therefore of also paramount importance. Selecting the therapeutic steps including diabetological aspects, we must constantly strive to improve the life quality. Rövidítések AGE = (advanced glycation endproduct) glikációs végtermék; CAPD = folyamatos (continuous) ambuláns peritonealis dialí-zis; CGMS = (Continuous Glucose Monitoring System) folyamatos szöveti glükózszint monitorozása; CKD = (chronic kidney disease) krónikus vesebetegség; CVD = (cardiovascular disease) cardiovascularis betegség; DM = diabetes mellitus (cukorbetegség); EPS = (encapsul...

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The Trio Trial – a Randomized Controlled Clinical Trial Evaluating the Effect of a Biocompatible Peritoneal Dialysis Solution on Residual Renal Function

Abstract: ISRCTN26252543.

Cited by 26 publications

References 14 publications

Current guidelines in peritoneal dialysis – Part II

Current guidelines in peritoneal dialysis – Part II

“Biocompatible” Neutral pH Low‐GDP Peritoneal Dialysis Solutions: Much Ado About Nothing?

Glükózterhelés a peritonealis dialízisben. Újabb elméleti megfontolások

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