BACKGROUND:Standard peritoneal dialysis (PD) solutions contain high levels of glucose and glucose degradation products (GDPs), both contributing to the formation of advanced glycation end products (AGEs). We studied the contribution to plasma GDP and AGE levels of 2 PD regimens that differ in glucose and GDP loads: high load [standard PD (sPD) using 4 glucose-lactate exchanges] and low load [1 amino acid exchange, 1 icodextrin exchange, and 2 glucose-bicarbonate/lactate exchanges ("NEPP")]. METHODS: In a prospective crossover study (2 periods of 24 weeks), new continuous ambulatory PD patients were randomized to NEPP-sPD (n = 23) or to sPD-NEPP (n = 27). RESULTS: After the start of PD, absolute increases were observed in plasma levels of 3-deoxyglucosone (3-DG, 220.4 nmol/L, p < 0.0001) and in N(ε)-(carboxymethyl) lysine (CML) in plasma proteins (0.02 μmol/L CML per 1 mol/L lysine, p < 0.0001). During the first 6 weeks, 3-DG tended to increase more with sPD treatment (p = 0.08), and CML, with NEPP treatment (p = 0.002). In both groups, N(ε)-(carboxyethyl)lysine (CEL) in plasma proteins declined significantly with the start of PD. Treatment with NEPP resulted in higher levels of methylglyoxal (MGO) and lower levels of 3-DG and CEL. Pentosidine in the albumin fraction tended to increase less during NEPP treatment. CONCLUSIONS: A low glucose and GDP PD regimen (NEPP) resulted in plasma levels of 3-DG and CEL that were lower than those with a glucose-based sPD regimen. Starting PD with NEPP was associated with a steeper increase in CML, and continuing treatment with NEPP resulted in higher MGO levels.
RCT Entities:
BACKGROUND: Standard peritoneal dialysis (PD) solutions contain high levels of glucose and glucose degradation products (GDPs), both contributing to the formation of advanced glycation end products (AGEs). We studied the contribution to plasma GDP and AGE levels of 2 PD regimens that differ in glucose and GDP loads: high load [standard PD (sPD) using 4 glucose-lactate exchanges] and low load [1 amino acid exchange, 1 icodextrin exchange, and 2 glucose-bicarbonate/lactate exchanges ("NEPP")]. METHODS: In a prospective crossover study (2 periods of 24 weeks), new continuous ambulatory PDpatients were randomized to NEPP-sPD (n = 23) or to sPD-NEPP (n = 27). RESULTS: After the start of PD, absolute increases were observed in plasma levels of 3-deoxyglucosone (3-DG, 220.4 nmol/L, p < 0.0001) and in N(ε)-(carboxymethyl) lysine (CML) in plasma proteins (0.02 μmol/L CML per 1 mol/L lysine, p < 0.0001). During the first 6 weeks, 3-DG tended to increase more with sPD treatment (p = 0.08), and CML, with NEPP treatment (p = 0.002). In both groups, N(ε)-(carboxyethyl)lysine (CEL) in plasma proteins declined significantly with the start of PD. Treatment with NEPP resulted in higher levels of methylglyoxal (MGO) and lower levels of 3-DG and CEL. Pentosidine in the albumin fraction tended to increase less during NEPP treatment. CONCLUSIONS: A low glucose and GDPPD regimen (NEPP) resulted in plasma levels of 3-DG and CEL that were lower than those with a glucose-based sPD regimen. Starting PD with NEPP was associated with a steeper increase in CML, and continuing treatment with NEPP resulted in higher MGO levels.
Authors: Jos van de Kerkhof; Casper G Schalkwijk; Constantijn J Konings; Emile C Cheriex; Frank M van der Sande; Peter G Scheffer; Piet M ter Wee; Karel M Leunissen; Jeroen P Kooman Journal: Nephrol Dial Transplant Date: 2004-04 Impact factor: 5.992
Authors: Caatje Y le Poole; Casper G Schalkwijk; Tom Teerlink; Rob M Valentijn; Piet M Ter Wee; Frans J van Ittersum Journal: Perit Dial Int Date: 2013 Mar-Apr Impact factor: 1.756
Authors: Remy J H Martens; Natascha J H Broers; Bernard Canaud; Maarten H L Christiaans; Tom Cornelis; Adelheid Gauly; Marc M H Hermans; Constantijn J A M Konings; Frank M van der Sande; Jean L J M Scheijen; Frank Stifft; Jeroen P Kooman; Casper G Schalkwijk Journal: Clin Kidney J Date: 2019-08-28
Authors: Remy J H Martens; Natascha J H Broers; Bernard Canaud; Maarten H L Christiaans; Tom Cornelis; Adelheid Gauly; Marc M H Hermans; Constantijn J A M Konings; Frank M van der Sande; Jean L J M Scheijen; Frank Stifft; Joris J J M Wirtz; Jeroen P Kooman; Casper G Schalkwijk Journal: PLoS One Date: 2019-08-13 Impact factor: 3.240
Authors: Htay Htay; David W Johnson; Kathryn J Wiggins; Sunil V Badve; Jonathan C Craig; Giovanni Fm Strippoli; Yeoungjee Cho Journal: Cochrane Database Syst Rev Date: 2018-10-26