Susan Yung1, Sing Leung Lui2, Chris K F Ng1, Andrew Yim1, Maggie K M Ma3, Kin Yee Lo4, Chik Cheung Chow5, Kwok Hong Chu6, Wai Leung Chak7, Man Fai Lam3, Chun Yu Yung8, Terence P S Yip2, Sunny Wong9, Colin S O Tang1, Flora S K Ng10, Tak Mao Chan11. 1. Department of Medicine, University of Hong Kong, Hong Kong. 2. Tung Wah Hospital, Hong Kong. 3. Queen Mary Hospital, Hong Kong. 4. Kwong Wah Hospital, Hong Kong. 5. Pamela Youde Nethersole Eastern Hospital, Hong Kong. 6. Princess Margaret Hospital, Hong Kong. 7. Queen Elizabeth Hospital, Hong Kong. 8. Tuen Mun Hospital, Hong Kong. 9. United Christian Hospital, Hong Kong. 10. Department of Medicine, University of Hong Kong, Hong Kong Tung Wah Hospital, Hong Kong. 11. Department of Medicine, University of Hong Kong, Hong Kong Queen Mary Hospital, Hong Kong.
Abstract
BACKGROUND: The impact of a low-glucose peritoneal dialysis (PD) regimen on biomarkers of peritoneal inflammation, fibrosis and membrane integrity remains to be investigated. METHODS: In a randomized, prospective study, 80 incident PD patients received either a low-glucose regimen comprising Physioneal (P), Extraneal (E) and Nutrineal (N) (Baxter Healthcare Corporation, Deerfield, IL, USA) (PEN group), or Dianeal (control group) for 12 months, after which both groups continued with Dianeal dialysis for 6 months. Serum and dialysate levels of vascular endothelial growth factor (VEGF), decorin, hepatocyte growth factor (HGF), interleukin-6 (IL-6), macrophage migration inhibitory factor (MIF), hyaluronan (HA), adiponectin, soluble-intracellular adhesion molecule (s-ICAM), vascular cell adhesion molecule-1 (VCAM-1) and P-selectin, and dialysate cancer antigen 125 (CA125), were measured after 12 and 18 months. This paper focuses on results after 12 months, when patients in the PEN group changed to glucose-based PD fluid (PDF). RESULTS: At the end of 12 months, effluent dialysate levels of CA125, decorin, HGF, IL-6, adiponectin and adhesion molecules were significantly higher in the PEN group compared to controls, but all decreased after patients switched to glucose-based PDF. Macrophage migration inhibitory factor level was lower in the PEN group but increased after changing to glucose-based PDF and was similar to controls at 18 months. Serum adiponectin level was higher in the PEN group at 12 months, but was similar in the 2 groups at 18 months. Body weight, residual renal function, ultrafiltration volume and total Kt/V did not differ between both groups. Dialysate-to-plasma creatinine ratio at 4 h was higher in the PEN group at 12 months and remained so after switching to glucose-based PDF. CONCLUSION: Changes in the biomarkers suggest that the PEN PD regimen may be associated with better preservation of peritoneal membrane integrity and reduced systemic vascular endothelial injury.
RCT Entities:
BACKGROUND: The impact of a low-glucose peritoneal dialysis (PD) regimen on biomarkers of peritoneal inflammation, fibrosis and membrane integrity remains to be investigated. METHODS: In a randomized, prospective study, 80 incident PDpatients received either a low-glucose regimen comprising Physioneal (P), Extraneal (E) and Nutrineal (N) (Baxter Healthcare Corporation, Deerfield, IL, USA) (PEN group), or Dianeal (control group) for 12 months, after which both groups continued with Dianeal dialysis for 6 months. Serum and dialysate levels of vascular endothelial growth factor (VEGF), decorin, hepatocyte growth factor (HGF), interleukin-6 (IL-6), macrophage migration inhibitory factor (MIF), hyaluronan (HA), adiponectin, soluble-intracellular adhesion molecule (s-ICAM), vascular cell adhesion molecule-1 (VCAM-1) and P-selectin, and dialysate cancer antigen 125 (CA125), were measured after 12 and 18 months. This paper focuses on results after 12 months, when patients in the PEN group changed to glucose-based PD fluid (PDF). RESULTS: At the end of 12 months, effluent dialysate levels of CA125, decorin, HGF, IL-6, adiponectin and adhesion molecules were significantly higher in the PEN group compared to controls, but all decreased after patients switched to glucose-based PDF. Macrophage migration inhibitory factor level was lower in the PEN group but increased after changing to glucose-based PDF and was similar to controls at 18 months. Serum adiponectin level was higher in the PEN group at 12 months, but was similar in the 2 groups at 18 months. Body weight, residual renal function, ultrafiltration volume and total Kt/V did not differ between both groups. Dialysate-to-plasma creatinine ratio at 4 h was higher in the PEN group at 12 months and remained so after switching to glucose-based PDF. CONCLUSION: Changes in the biomarkers suggest that the PENPD regimen may be associated with better preservation of peritoneal membrane integrity and reduced systemic vascular endothelial injury.
Authors: W A Border; N A Noble; T Yamamoto; J R Harper; Y u Yamaguchi; M D Pierschbacher; E Ruoslahti Journal: Nature Date: 1992-11-26 Impact factor: 49.962
Authors: Sing Leung Lui; Susan Yung; Andrew Yim; Kui Man Wong; Kwok Lung Tong; Kin Shing Wong; Chun Sang Li; Tak Cheung Au; Wai Kei Lo; Yiu Wing Ho; Flora Ng; Colin Tang; Tak Mao Chan Journal: Am J Kidney Dis Date: 2012-07-25 Impact factor: 8.860
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
Authors: Na Jiang; Qing Zhang; Mel Km Chau; Ming S Yip; Sing Leung Lui; Stephanie Liu; Kent Man Chu; Hextan Ys Ngan; Tak Mao Chan; Susan Yung Journal: EBioMedicine Date: 2020-02-12 Impact factor: 8.143