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Peritoneal transport during dialysis with amino acid-based solutions.
Perit Dial Int. 1993; 13(4):280-8.PD

Abstract

OBJECTIVE

To evaluate the potential clinical role of amino acids as an osmotic agent.

DESIGN

The peritoneal transport of fluid, amino acids, and other solutes was investigated during a 6-hour single-cycle peritoneal dialysis with PDA 1% versus 1.36% glucose (n = 6) or PDA 2.7% versus 3.86% glucose solution (n = 9).

PATIENTS

Fifteen stable nondiabetic continuous ambulatory peritoneal dialysis (CAPD) patients.

RESULTS

The fractional absorption of the osmotic agents at 6 hours was higher with PDA 2.7% versus glucose 3.86% (p < 0.005). The diffusive mass transport coefficient, KBD, calculated for a period of dialysate isovolemia was higher with PDA 2.7% versus PDA 1% for essential, nonessential (p < 0.005), and total (p < 0.05) amino acids. The intraperitoneal volume-over-time curves and KBD values for urea, creatinine, glucose, albumin, beta 2-microglobulin, and total protein did not differ between the amino acid solutions and the corresponding glucose solutions. KBD for urea was significantly higher during the dwell with PDA 2.7% versus PDA 1% (p < 0.05). Plasma amino acid concentrations increased substantially during the first 1-2 hours and then decreased gradually. Valine and methionine rose to 792% and 1119% of baseline values, respectively.

CONCLUSIONS

We conclude that the peritoneal transport of fluid and investigated solutes, except amino acids, was not different with the amino acid solutions compared with the corresponding equimolar glucose solutions. However, ultrafiltration tended to be lower with amino acid solutions. Furthermore, the fractional absorption of amino acids and KBD values for amino acids was higher with PDA 2.7% versus PDA 1%, suggesting an effect of the hypertonic amino acid solution on the peritoneal membrane transport properties. Also, the hypertonic PDA 2.7% solution yielded nonphysiologically high plasma levels of several amino acids. We therefore consider this solution not to be safe enough for long-term clinical use.

Authors+Show Affiliations

Department of Renal Medicine, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8241328

Citation

Park, M S., et al. "Peritoneal Transport During Dialysis With Amino Acid-based Solutions." Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, vol. 13, no. 4, 1993, pp. 280-8.
Park MS, Heimbürger O, Bergström J, et al. Peritoneal transport during dialysis with amino acid-based solutions. Perit Dial Int. 1993;13(4):280-8.
Park, M. S., Heimbürger, O., Bergström, J., Waniewski, J., Werynski, A., & Lindholm, B. (1993). Peritoneal transport during dialysis with amino acid-based solutions. Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, 13(4), 280-8.
Park MS, et al. Peritoneal Transport During Dialysis With Amino Acid-based Solutions. Perit Dial Int. 1993;13(4):280-8. PubMed PMID: 8241328.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Peritoneal transport during dialysis with amino acid-based solutions. AU - Park,M S, AU - Heimbürger,O, AU - Bergström,J, AU - Waniewski,J, AU - Werynski,A, AU - Lindholm,B, PY - 1993/1/1/pubmed PY - 1993/1/1/medline PY - 1993/1/1/entrez SP - 280 EP - 8 JF - Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis JO - Perit Dial Int VL - 13 IS - 4 N2 - OBJECTIVE: To evaluate the potential clinical role of amino acids as an osmotic agent. DESIGN: The peritoneal transport of fluid, amino acids, and other solutes was investigated during a 6-hour single-cycle peritoneal dialysis with PDA 1% versus 1.36% glucose (n = 6) or PDA 2.7% versus 3.86% glucose solution (n = 9). PATIENTS: Fifteen stable nondiabetic continuous ambulatory peritoneal dialysis (CAPD) patients. RESULTS: The fractional absorption of the osmotic agents at 6 hours was higher with PDA 2.7% versus glucose 3.86% (p < 0.005). The diffusive mass transport coefficient, KBD, calculated for a period of dialysate isovolemia was higher with PDA 2.7% versus PDA 1% for essential, nonessential (p < 0.005), and total (p < 0.05) amino acids. The intraperitoneal volume-over-time curves and KBD values for urea, creatinine, glucose, albumin, beta 2-microglobulin, and total protein did not differ between the amino acid solutions and the corresponding glucose solutions. KBD for urea was significantly higher during the dwell with PDA 2.7% versus PDA 1% (p < 0.05). Plasma amino acid concentrations increased substantially during the first 1-2 hours and then decreased gradually. Valine and methionine rose to 792% and 1119% of baseline values, respectively. CONCLUSIONS: We conclude that the peritoneal transport of fluid and investigated solutes, except amino acids, was not different with the amino acid solutions compared with the corresponding equimolar glucose solutions. However, ultrafiltration tended to be lower with amino acid solutions. Furthermore, the fractional absorption of amino acids and KBD values for amino acids was higher with PDA 2.7% versus PDA 1%, suggesting an effect of the hypertonic amino acid solution on the peritoneal membrane transport properties. Also, the hypertonic PDA 2.7% solution yielded nonphysiologically high plasma levels of several amino acids. We therefore consider this solution not to be safe enough for long-term clinical use. SN - 0896-8608 UR - https://www.unboundmedicine.com/medline/citation/8241328/Peritoneal_transport_during_dialysis_with_amino_acid_based_solutions_ L2 - http://www.pdiconnect.com/cgi/pmidlookup?view=long&amp;pmid=8241328 DB - PRIME DP - Unbound Medicine ER -