Low glucose degradation products dialysis solution modulates the levels of surrogate markers of peritoneal inflammation, integrity, and angiogenesis: Preliminary report

Yong Lim Kim, Junyoung Do, Sun Hee Park, Kyuhyang Cho, Jongwon Park, Kyungwoo Yoon, Dong Kyu Cho, Eun Gyui Lee, In-San Kim

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

The presence of glucose degradation products (GDPs) in peritoneal dialysis (PD) fluids has many adverse effects, namely clinically significant abdominal pain or discomfort during infusion, inhibition of cell proliferation, impairment of inflammatory cell function, cytotoxicity, and the induction of vascular endothelial growth factor (VEGF). In a prospective, randomized, controlled trial comparing a low GDP PD solution (pH 7.0, two compartment bag: low GDP) to conventional PD solution (pH 5.5: high GDP), the overnight dialysate levels of the markers of inflammation/wound healing (hyaluronic acid (HA)), mesothelial cell mass/membrane integrity (cancer antigen 125 (CA125)), and angiogenesis (VEGF) were assessed over a 12-month period. Twenty-six newly commencing continuous ambulatory peritoneal dialysis (CAPD) patients were randomly assigned to either the Low GDP group (n = 16) or the High GDP group (n = 10). Standard peritoneal permeability analysis for membrane transport characteristics and dialysis adequacy with nutritional status (serum albumin, nPCR) were evaluated at 1, 6, and 12 months. In patients treated with high GDP solution, there was significant increase in VEGF with time (time = 1 month, 67. 2 ± 10.8; time = 6 months, 189.8 ± 90.2; and time =12 months, 169.3 ± 83.1 pg/mg of protein; P < 0.05). There was no significant change of VEGF with time in the low GDP group. Significantly higher concentrations of CA125 (65.5 ± 10.4 vs. 19.7 ± 2.6 at 1 month, P < 0.0001; 66.6 ± 9.8 vs. 29.7 ± 5.0 at 6 months, P < 0.01; 68.7 ± 10.5 vs. 30.7 ± 10.0 U/mL at 12 months, P < 0.01) and lower concentrations of HA (114.6 ± 18.8 vs. 254.3 ± 69.2 at 1 month, P < 0.05; 417.5 ± 57.2 vs. 1277.5 ± 367.9 ng/mg of protein at 12 month, P < 0.05) were observed in the low GDP group compared with the high GDP group. In conclusion, continuous therapy with the low GDP solution modulates the levels of surrogate markers of peritoneal inflammation, integrity and angiogenesis. The results strongly suggest that the use of a low GDP solution would be beneficial to maintain the function and structural integrity of the peritoneal membrane.

Original languageEnglish
JournalNephrology
Volume8
Issue numberSUPPL.
DOIs
Publication statusPublished - 2003 Oct 1
Externally publishedYes

Fingerprint

Dialysis Solutions
Biomarkers
Inflammation
Glucose
Vascular Endothelial Growth Factor A
Peritoneal Dialysis
Hyaluronic Acid
Antigens
Membranes
Continuous Ambulatory Peritoneal Dialysis
Ascitic Fluid
Nutritional Status
Serum Albumin
Wound Healing
Abdominal Pain
Dialysis
Permeability
Neoplasms
Proteins
Randomized Controlled Trials

Keywords

  • Biocompatibility
  • Dialysis solution
  • Effluent markers
  • Glucose degradation products

ASJC Scopus subject areas

  • Nephrology

Cite this

Low glucose degradation products dialysis solution modulates the levels of surrogate markers of peritoneal inflammation, integrity, and angiogenesis : Preliminary report. / Kim, Yong Lim; Do, Junyoung; Park, Sun Hee; Cho, Kyuhyang; Park, Jongwon; Yoon, Kyungwoo; Cho, Dong Kyu; Lee, Eun Gyui; Kim, In-San.

In: Nephrology, Vol. 8, No. SUPPL., 01.10.2003.

Research output: Contribution to journalArticle

Kim, Yong Lim ; Do, Junyoung ; Park, Sun Hee ; Cho, Kyuhyang ; Park, Jongwon ; Yoon, Kyungwoo ; Cho, Dong Kyu ; Lee, Eun Gyui ; Kim, In-San. / Low glucose degradation products dialysis solution modulates the levels of surrogate markers of peritoneal inflammation, integrity, and angiogenesis : Preliminary report. In: Nephrology. 2003 ; Vol. 8, No. SUPPL.
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abstract = "The presence of glucose degradation products (GDPs) in peritoneal dialysis (PD) fluids has many adverse effects, namely clinically significant abdominal pain or discomfort during infusion, inhibition of cell proliferation, impairment of inflammatory cell function, cytotoxicity, and the induction of vascular endothelial growth factor (VEGF). In a prospective, randomized, controlled trial comparing a low GDP PD solution (pH 7.0, two compartment bag: low GDP) to conventional PD solution (pH 5.5: high GDP), the overnight dialysate levels of the markers of inflammation/wound healing (hyaluronic acid (HA)), mesothelial cell mass/membrane integrity (cancer antigen 125 (CA125)), and angiogenesis (VEGF) were assessed over a 12-month period. Twenty-six newly commencing continuous ambulatory peritoneal dialysis (CAPD) patients were randomly assigned to either the Low GDP group (n = 16) or the High GDP group (n = 10). Standard peritoneal permeability analysis for membrane transport characteristics and dialysis adequacy with nutritional status (serum albumin, nPCR) were evaluated at 1, 6, and 12 months. In patients treated with high GDP solution, there was significant increase in VEGF with time (time = 1 month, 67. 2 ± 10.8; time = 6 months, 189.8 ± 90.2; and time =12 months, 169.3 ± 83.1 pg/mg of protein; P < 0.05). There was no significant change of VEGF with time in the low GDP group. Significantly higher concentrations of CA125 (65.5 ± 10.4 vs. 19.7 ± 2.6 at 1 month, P < 0.0001; 66.6 ± 9.8 vs. 29.7 ± 5.0 at 6 months, P < 0.01; 68.7 ± 10.5 vs. 30.7 ± 10.0 U/mL at 12 months, P < 0.01) and lower concentrations of HA (114.6 ± 18.8 vs. 254.3 ± 69.2 at 1 month, P < 0.05; 417.5 ± 57.2 vs. 1277.5 ± 367.9 ng/mg of protein at 12 month, P < 0.05) were observed in the low GDP group compared with the high GDP group. In conclusion, continuous therapy with the low GDP solution modulates the levels of surrogate markers of peritoneal inflammation, integrity and angiogenesis. The results strongly suggest that the use of a low GDP solution would be beneficial to maintain the function and structural integrity of the peritoneal membrane.",
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T1 - Low glucose degradation products dialysis solution modulates the levels of surrogate markers of peritoneal inflammation, integrity, and angiogenesis

T2 - Preliminary report

AU - Kim, Yong Lim

AU - Do, Junyoung

AU - Park, Sun Hee

AU - Cho, Kyuhyang

AU - Park, Jongwon

AU - Yoon, Kyungwoo

AU - Cho, Dong Kyu

AU - Lee, Eun Gyui

AU - Kim, In-San

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N2 - The presence of glucose degradation products (GDPs) in peritoneal dialysis (PD) fluids has many adverse effects, namely clinically significant abdominal pain or discomfort during infusion, inhibition of cell proliferation, impairment of inflammatory cell function, cytotoxicity, and the induction of vascular endothelial growth factor (VEGF). In a prospective, randomized, controlled trial comparing a low GDP PD solution (pH 7.0, two compartment bag: low GDP) to conventional PD solution (pH 5.5: high GDP), the overnight dialysate levels of the markers of inflammation/wound healing (hyaluronic acid (HA)), mesothelial cell mass/membrane integrity (cancer antigen 125 (CA125)), and angiogenesis (VEGF) were assessed over a 12-month period. Twenty-six newly commencing continuous ambulatory peritoneal dialysis (CAPD) patients were randomly assigned to either the Low GDP group (n = 16) or the High GDP group (n = 10). Standard peritoneal permeability analysis for membrane transport characteristics and dialysis adequacy with nutritional status (serum albumin, nPCR) were evaluated at 1, 6, and 12 months. In patients treated with high GDP solution, there was significant increase in VEGF with time (time = 1 month, 67. 2 ± 10.8; time = 6 months, 189.8 ± 90.2; and time =12 months, 169.3 ± 83.1 pg/mg of protein; P < 0.05). There was no significant change of VEGF with time in the low GDP group. Significantly higher concentrations of CA125 (65.5 ± 10.4 vs. 19.7 ± 2.6 at 1 month, P < 0.0001; 66.6 ± 9.8 vs. 29.7 ± 5.0 at 6 months, P < 0.01; 68.7 ± 10.5 vs. 30.7 ± 10.0 U/mL at 12 months, P < 0.01) and lower concentrations of HA (114.6 ± 18.8 vs. 254.3 ± 69.2 at 1 month, P < 0.05; 417.5 ± 57.2 vs. 1277.5 ± 367.9 ng/mg of protein at 12 month, P < 0.05) were observed in the low GDP group compared with the high GDP group. In conclusion, continuous therapy with the low GDP solution modulates the levels of surrogate markers of peritoneal inflammation, integrity and angiogenesis. The results strongly suggest that the use of a low GDP solution would be beneficial to maintain the function and structural integrity of the peritoneal membrane.

AB - The presence of glucose degradation products (GDPs) in peritoneal dialysis (PD) fluids has many adverse effects, namely clinically significant abdominal pain or discomfort during infusion, inhibition of cell proliferation, impairment of inflammatory cell function, cytotoxicity, and the induction of vascular endothelial growth factor (VEGF). In a prospective, randomized, controlled trial comparing a low GDP PD solution (pH 7.0, two compartment bag: low GDP) to conventional PD solution (pH 5.5: high GDP), the overnight dialysate levels of the markers of inflammation/wound healing (hyaluronic acid (HA)), mesothelial cell mass/membrane integrity (cancer antigen 125 (CA125)), and angiogenesis (VEGF) were assessed over a 12-month period. Twenty-six newly commencing continuous ambulatory peritoneal dialysis (CAPD) patients were randomly assigned to either the Low GDP group (n = 16) or the High GDP group (n = 10). Standard peritoneal permeability analysis for membrane transport characteristics and dialysis adequacy with nutritional status (serum albumin, nPCR) were evaluated at 1, 6, and 12 months. In patients treated with high GDP solution, there was significant increase in VEGF with time (time = 1 month, 67. 2 ± 10.8; time = 6 months, 189.8 ± 90.2; and time =12 months, 169.3 ± 83.1 pg/mg of protein; P < 0.05). There was no significant change of VEGF with time in the low GDP group. Significantly higher concentrations of CA125 (65.5 ± 10.4 vs. 19.7 ± 2.6 at 1 month, P < 0.0001; 66.6 ± 9.8 vs. 29.7 ± 5.0 at 6 months, P < 0.01; 68.7 ± 10.5 vs. 30.7 ± 10.0 U/mL at 12 months, P < 0.01) and lower concentrations of HA (114.6 ± 18.8 vs. 254.3 ± 69.2 at 1 month, P < 0.05; 417.5 ± 57.2 vs. 1277.5 ± 367.9 ng/mg of protein at 12 month, P < 0.05) were observed in the low GDP group compared with the high GDP group. In conclusion, continuous therapy with the low GDP solution modulates the levels of surrogate markers of peritoneal inflammation, integrity and angiogenesis. The results strongly suggest that the use of a low GDP solution would be beneficial to maintain the function and structural integrity of the peritoneal membrane.

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