Effects of Steady Glucose Concentration Peritoneal Dialysis on Ultrafiltration Volume and Sodium Removal : A Pilot Crossover Trial
Heimbürger, Olof ; Hegbrant, Jörgen LU ; Martus, Giedre LU
; Wilkie, Martin
; De Leon, Charlotte
; Carlsson, Ola
and Johansson, Ann Cathrine
(2024)
In Clinical Journal of the American Society of Nephrology
19(2).
p.224-232
- Abstract
Background: Volume overload is common in patients treated with peritoneal dialysis (PD) and is associated with poor clinical outcome. Steady concentration PD is where a continuous glucose infusion maintains the intraperitoneal glucose concentration and as a result provides continuous ultrafiltration throughout the dwell. The primary objective of this study was to investigate the ultrafiltration rate and glucose ultrafiltration efficiency for steady concentration PD in comparison with a standard continuous ambulatory PD (CAPD) dwell, using the novel Carry Life UF device.MethodsEight stable patients treated with PD (six fast and two fast average transporters) were investigated four times: a standard 4-hour CAPD dwell with 2 L of 2.5%... (More)
Background: Volume overload is common in patients treated with peritoneal dialysis (PD) and is associated with poor clinical outcome. Steady concentration PD is where a continuous glucose infusion maintains the intraperitoneal glucose concentration and as a result provides continuous ultrafiltration throughout the dwell. The primary objective of this study was to investigate the ultrafiltration rate and glucose ultrafiltration efficiency for steady concentration PD in comparison with a standard continuous ambulatory PD (CAPD) dwell, using the novel Carry Life UF device.MethodsEight stable patients treated with PD (six fast and two fast average transporters) were investigated four times: a standard 4-hour CAPD dwell with 2 L of 2.5% dextrose solution as control and three 5-hour steady concentration PD treatments (glucose dose 11, 14, 20 g/h, initial fill 1.5 L of 1.5% dextrose solution). All investigations were preceded by an overnight 2 L 7.5% icodextrin dwell.ResultsIntraperitoneal glucose concentration increased during the first 1-2 hours of the steady concentration PD treatments and remained stable thereafter. Ultrafiltration rates were significantly higher with steady concentration PD treatments (124±49, 146±63, and 168±78 mL/h with 11, 14, and 20 g/h, respectively, versus 40±60 mL/h with the control dwell). Sodium removal and glucose ultrafiltration efficiency (ultrafiltration volume/gram glucose uptake) were significantly higher with steady concentration PD treatments versus the control dwell, where the 11 g/h glucose dose was most efficient.ConclusionsSteady concentration PD performed with the Carry Life UF device resulted in higher ultrafiltration rates, more efficient use of glucose (increased ultrafiltration volume/gram glucose absorbed), and greater sodium removal compared with a standard 2.5% dextrose CAPD dwell.Clinical Trial registry name and registration numberA Performance Analysis of the Peritoneal Ultrafiltration (PUF) Achieved With the Carry Life®UF, NCT03724682.
(Less)
- author
- Heimbürger, Olof
; Hegbrant, Jörgen
LU
; Martus, Giedre
LU
; Wilkie, Martin
; De Leon, Charlotte
; Carlsson, Ola
and Johansson, Ann Cathrine
- organization
- publishing date
- 2024-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- clinical trial, dialysis, electrolytes, peritoneal dialysis, ultrafiltration
- in
- Clinical Journal of the American Society of Nephrology
- volume
- 19
- issue
- 2
- pages
- 9 pages
- publisher
- Amer Soc Nephrology
- external identifiers
-
- scopus:85189071503
- pmid:37902732
- ISSN
- 1555-9041
- DOI
- 10.2215/CJN.0000000000000342
- language
- English
- LU publication?
- yes
- id
- d5f9db90-6df8-4a2e-8f59-995ffb07198b
- date added to LUP
- 2025-01-09 15:45:21
- date last changed
- 2025-07-11 20:25:06
@article{d5f9db90-6df8-4a2e-8f59-995ffb07198b,
abstract = {{<p>Background: Volume overload is common in patients treated with peritoneal dialysis (PD) and is associated with poor clinical outcome. Steady concentration PD is where a continuous glucose infusion maintains the intraperitoneal glucose concentration and as a result provides continuous ultrafiltration throughout the dwell. The primary objective of this study was to investigate the ultrafiltration rate and glucose ultrafiltration efficiency for steady concentration PD in comparison with a standard continuous ambulatory PD (CAPD) dwell, using the novel Carry Life UF device.MethodsEight stable patients treated with PD (six fast and two fast average transporters) were investigated four times: a standard 4-hour CAPD dwell with 2 L of 2.5% dextrose solution as control and three 5-hour steady concentration PD treatments (glucose dose 11, 14, 20 g/h, initial fill 1.5 L of 1.5% dextrose solution). All investigations were preceded by an overnight 2 L 7.5% icodextrin dwell.ResultsIntraperitoneal glucose concentration increased during the first 1-2 hours of the steady concentration PD treatments and remained stable thereafter. Ultrafiltration rates were significantly higher with steady concentration PD treatments (124±49, 146±63, and 168±78 mL/h with 11, 14, and 20 g/h, respectively, versus 40±60 mL/h with the control dwell). Sodium removal and glucose ultrafiltration efficiency (ultrafiltration volume/gram glucose uptake) were significantly higher with steady concentration PD treatments versus the control dwell, where the 11 g/h glucose dose was most efficient.ConclusionsSteady concentration PD performed with the Carry Life UF device resulted in higher ultrafiltration rates, more efficient use of glucose (increased ultrafiltration volume/gram glucose absorbed), and greater sodium removal compared with a standard 2.5% dextrose CAPD dwell.Clinical Trial registry name and registration numberA Performance Analysis of the Peritoneal Ultrafiltration (PUF) Achieved With the Carry Life<sup>®</sup>UF, NCT03724682.</p>}},
author = {{Heimbürger, Olof and Hegbrant, Jörgen and Martus, Giedre and Wilkie, Martin and De Leon, Charlotte and Carlsson, Ola and Johansson, Ann Cathrine}},
issn = {{1555-9041}},
keywords = {{clinical trial; dialysis; electrolytes; peritoneal dialysis; ultrafiltration}},
language = {{eng}},
number = {{2}},
pages = {{224--232}},
publisher = {{Amer Soc Nephrology}},
series = {{Clinical Journal of the American Society of Nephrology}},
title = {{Effects of Steady Glucose Concentration Peritoneal Dialysis on Ultrafiltration Volume and Sodium Removal : A Pilot Crossover Trial}},
url = {{http://dx.doi.org/10.2215/CJN.0000000000000342}},
doi = {{10.2215/CJN.0000000000000342}},
volume = {{19}},
year = {{2024}},
}