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01-05-2019 | Original article

Effects of long-term treatment with low-GDP, pH-neutral solutions on peritoneal membranes in peritoneal dialysis patients

Authors: Mitsuhiro Tawada, Chieko Hamada, Yasuhiro Suzuki, Fumiko Sakata, Ting Sun, Hiroshi Kinashi, Takayuki Katsuno, Yoshifumi Takei, Shoichi Maruyama, Kazuho Honda, Masashi Mizuno, Yasuhiko Ito

Published in: Clinical and Experimental Nephrology | Issue 5/2019

Abstract

Background

The morphological changes induced by bio-incompatible peritoneal dialysis (PD) solutions are well known. However, the morphological damage induced by long-term low-glucose degradation product (GDP), pH-neutral solutions has not been reported in detail. The aim of this study was to investigate the long-term effects of pH-neutral PD solutions on morphological and functional changes in the peritoneal membrane.

Methods

We assessed peritoneal membrane biopsy samples from PD patients treated with acidic (Conventional group) or pH-neutral solutions (pH-neutral group) using pathology and immunopathology techniques.

Results

Analyses of 54 Conventional and 73 pH-neutral group samples showed that the peritoneal membrane was thicker (P < 0.001), the ratio of luminal diameter to vessel diameter (L/V ratio) was significantly smaller (P < 0.001), and advanced glycation end-product (AGE) accumulation was higher in the Conventional than in the pH-neutral group (P < 0.001). Comparison of samples from patients in the Conventional (n = 33) and pH-neutral groups (n = 33) who were treated for 4–10 years also showed significant differences in peritoneal thickness, L/V ratio and AGE score. Furthermore, the L/V ratio in the Conventional group significantly decreased over time (P < 0.01); however, no such change was seen in the pH-neutral group. Peritoneal membrane thickness was not associated with PD duration in both groups. Dialysate-to-plasma ratio of creatinine and L/V ratio negatively correlated with PD treatment duration in the Conventional group, but not in the pH-neutral group.

Conclusions

These findings suggest that pH-neutral solutions prevent the morphological and functional peritoneal changes induced by long-term PD treatment.

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Title: Effects of long-term treatment with low-GDP, pH-neutral solutions on peritoneal membranes in peritoneal dialysis patients
Authors: Mitsuhiro Tawada
Chieko Hamada
Yasuhiro Suzuki
Fumiko Sakata
Ting Sun
Hiroshi Kinashi
Takayuki Katsuno
Yoshifumi Takei
Shoichi Maruyama
Kazuho Honda
Masashi Mizuno
Yasuhiko Ito
Publication date: 01-05-2019
Publisher: Springer Singapore
Published in: Clinical and Experimental Nephrology / Issue 5/2019
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI: https://doi.org/10.1007/s10157-018-1679-7

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Effects of long-term treatment with low-GDP, pH-neutral solutions on peritoneal membranes in peritoneal dialysis patients

Abstract

Background

Methods

Results

Conclusions

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