Low- verus conventional-level of glucose peritoneal dialysis regimes: comparison of inflammatory and fibrotic mediators in peritoneal dialysate

Session: Peritoneal dialysis: SU380INTRODUCTION AND AIMS: New peritoneal dialysis fluids (PDF) such as Extraneal, Nutrineal, and Physioneal offer the advantages of reduced glucose exposure and improved biocompatibility, compared with conventional glucose-based PDF. We investigated the effect of these new PDFs on peritoneal inflammation, fibrosis, and clinical parameters. METHODS: Eighty new PD patients were randomized to receive PD treatment with either a low-glucose regimen comprising Physioneal, Nutrineal, and Extraneal (PEN) or with conventional glucose-based dialysate (Dianeal) (Controls) for 12 months. PDF and serum samples were collected at baseline then every 6 months, and the levels of hyaluronan (HA), nitric oxide (NO) and CA125 determined. Residual renal function, dialysis adequacy and peritoneal solute transport rate were also measured. RESULTS: Dialysate CA125 levels increased over time in PEN group, and were significantly higher than those in Controls (p<0.01). Dialysate NO level decreased in the PEN group but rose in Controls over the 12 month period (p