Effects of Steady Glucose Concentration Peritoneal Dialysis on Ultrafiltration Volume and Sodium Removal: A Pilot Crossover Trial

Olof Heimbürger, Jörgen Hegbrant, Giedre Martus, Martin Wilkie, Charlotte De Leon, Ola Carlsson, Ann Cathrine Johansson

Research output: Contribution to journalArticlepeer-review

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% 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.

Original languageEnglish
Pages (from-to)224-232
Number of pages9
JournalClinical Journal of the American Society of Nephrology
Volume19
Issue number2
DOIs
Publication statusPublished - 2024 Feb

Subject classification (UKÄ)

  • Urology and Nephrology

Free keywords

  • clinical trial
  • dialysis
  • electrolytes
  • peritoneal dialysis
  • ultrafiltration

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