Nitta Kosaku
   Department   Other, Other
   Position  
Article types Original article
Language English
Peer review Peer reviewed
Title NEUTRAL SOLUTION LOW IN GLUCOSE DEGRADATION PRODUCTS IS ASSOCIATED WITH LESS PERITONEAL FIBROSIS AND VASCULAR SCLEROSIS IN PATIENTS RECEIVING PERITONEAL DIALYSIS.
Journal Formal name:Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis
Abbreviation:Perit Dial Int
ISSN code:1718-4304(Electronic)0896-8608(Linking)
Volume, Issue, Page 33(3),pp.242-251
Author and coauthor Kawanishi Kunio†, Honda Kazuho, Tsukada Misao, Oda Hideaki, Nitta Kosaku*
Publication date 2012/11
Summary BACKGROUND: The effects of novel biocompatible peritoneal dialysis (PD) solutions on human peritoneal membrane pathology have yet to be determined. Quantitative evaluation of human peritoneal biopsy specimens may reveal the effects of the new solutions on peritoneal membrane pathology. METHODS: Peritoneal specimens from 24 PD patients being treated with either acidic solution containing high-glucose degradation products [GDPs (n = 12)]or neutral solution with low GDPs (n = 12) were investigated at the end of PD. As controls, pre-PD peritoneal specimens, obtained from 13 patients at PD catheter insertion, were also investigated. The extent of peritoneal fibrosis, vascular sclerosis, and advanced glycation end-product (AGE) accumulation were evaluated by quantitative or semi-quantitative methods. The average densities of CD31-positive vessels and podoplanin-positive lymphatic vessels were also determined. RESULTS: Peritoneal membrane fibrosis, vascular sclerosis, and AGE accumulation were significantly suppressed in the neutral group compared with the acidic group. The neutral group also showed lower peritoneal equilibration test scores and preserved ultrafiltration volume. The density of blood capillaries, but not of lymphatic capillaries, was significantly increased in the neutral group compared with the acidic and pre-PD groups. CONCLUSIONS: Neutral solutions with low GDPs are associated with less peritoneal membrane fibrosis and vascular sclerosis through suppression of AGE accumulation. However, contrary to expectation, blood capillary density was increased in the neutral group. The altered contents of the new PD solutions modified peritoneal membrane morphology and function in patients undergoing PD.
DOI 10.3747/pdi.2011.00270
Document No. 23123670