Peritoneal dialysis Abstracts. T: Peritoneal dialysis. Nephrology Dialysis Transplantation Vol. 16 n A187

Author: Henry Cameron
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Peritoneal dialysis

T: Peritoneal dialysis INFLUENCE OF POLYGLUCOSE DIALYSIS SOLUTION (PG-DS) ON THE PERITONEAL PERMEABILITY AE Grzegorzewska, D Antczak-Jedrzejczak, M Leander Chair and Dept. of Nephrology, Karol Marcinkowski University of Medical Sciences, Poznañ, Poland The aim of studies was an evaluation of the peritoneal permeability in standard PET performed before introduction, during administration and after discontinuation of PG-DS in patients treated with CAPD. In 14 patients (11 M., 3 F; age 45.1 ± 8.5 years) treated with CAPD for 17.5 ± 9.9 months, 7.5% PG-DS was applied for the overnight exchange replacing 3.86 or 2.27% glucose dialysis solution. Standard PET was carried out at 1.6 ± 0.8 months before PG-DS introduction (study period I, n = 14), after 1.2 ± 0.6 months of PG-DS administration (study period II, n = 14), after 4.4 ± 0.8 months of PGDS administration (study period III, n = 11), after 8.8 ± 2.2 months of PG-DS administration (study period IV, n = 9) and at 2.0 ± 0.6 months after PG-DS discontinuation (study period V, n = 11). D/P urea and creatinine as well as D/ D0 glucose were calculated at 0, 2 and 4 hours of PET. The control group was retrospectively selected taking into account both CAPD duration and the peritoneal permeability comparable to those in the PG-DS group at the study beginning. Patients of the control group underwent PET at the similar time intervals (control periods I – V). In the PG-DS group, an increasing tendency of D/P urea and D/P creatinine was shown during the consecutive study periods. This tendency continued after PGDS discontinuation. D/D 0 glucose was significantly higher only in PET performed during PG-DS administration (periods III and IV) as compared to results obtained in the preceding periods (I and II). In the control group, both D/ P urea and D/P creatinine remained unchanged, but D/D0 glucose was lower at 0 and 2 hour of PET in control period V as compared to respective values in the preceding control periods. The use of PG-DS in CAPD patients causes the prolonged increase in the peritoneal permeability from the vascular to the mesothelial side of the peritoneal membrane and reversibly decreases peritoneal permeability in the opposite direction.

MORPHO-FUNCTIONAL STUDY OF PERITONEUM IN PERITONEAL DIALYSIS S.V. Bertoli1, M.T. Barone2, L. Buzzi 1, A. De Vecchi3, M. Trezzi 2, G. Barbiano di Belgiojoso2 1 Renal Unit, Policlinico Multimedica, Sesto San Giovanni, Milan, Italy; 2Renal Unit, Sacco Hospital, Milan, Italy; 3Renal Unit, Policlinico Hospital, Milan, Italy. Peritoneal dialysis (PD) changes the morphology and the function of the peritoneal membrane (PM). The aim of the study was to classify the PM histologically and identify the relationship among dialytic, histo-pathologic and functional parameters in PD patients (P). We studied 31 P treated for 53±34 months with either CAPD (26 P) or APD (5 P), submitted to the peritoneal biopsy (PB) during the peritoneal catheter removal and classified as high (HT), medium-high (MHT) and medium-low (MLT) transporters according to the last peritoneal equilibration test made before the PB. For each P we calculated both the daily load of glucose (G) and the G infused during the whole treatment. We classified the PM specimens according to the alterations of the mesothelial layer (ML), the sub-mesothelial basement membrane (SMBM) and the sub-mesothelial layer (SML). P with a damaged ML had longer duration of the treatment than P with normal ML (p=0.0002); after 34 months, all the P showed mesothelial injuries: the lost of the ML was the most common finding. P with a sub-mesothelial collagen band and alterations of the SMBM and capillary basement membrane (CBM) were submitted to greater daily load of G than P with normal SMBM and CBM (p