Biokompatibilnost raztopin za peritonealno dializo : doktorsko delo
Pajek, Jernej
INTRODUCTION Besides infectious peritonitis, ultrafiltration failure is one ofthe main complications in peritoneal dialysis (PD) and an important cause ofits failure. Its development is associated ...with the insufficient biocompatibility of PD solutions. Important adverse factors of classical PD solutions are low pH, high lactate and glucose concentrations, and glucose degradation products (GDP). These factors contribute to inflammation and neoangiogenesis, which eventually lead to patohistological degeneration, dysfunction and ultrafitration failure of the peritoneal membrane. Recently, new PD solutions with a physiological pH, less lactate and less GDP have been introduced. AIMS To compare the biocompatibility properties of PD solutions, Physioneal (Baxter, USA) and Dianeal (same manufacturer), using a prospective,controlled, cross-over study on PD patients. Physioneal, compared to Dianeal, has a physiological pH, less lactate and less GDP. We tested: 1. Whether the PD solution Physioneal causes less intra-peritoneal inflammation; 2. If the use of Physioneal lowers the systemic inflammatory markers and epoetin resistance; 3. What the short-term impact of Physioneal is on the functioning of the peritoneal membrane and ultrafiltration. HYPOTHESIS We assumed that Physioneal causes a lower inflammatory activation of peritoneal cells and a lower level of systemic inflammatory markers. Lower intra-peritoneal and systemic inflammation should consequentually lead to lower epoetin resistance. We expected Physioneal to have equivalent or superior ultrafiltration compared to Dianeal. METHODS Twenty-six stable PD patients dialysed for at least 3 months were included in the study. Each patient received 3 months of therapy with Physioneal and Dianeal in a randomized sequence. At the end of each 3-month period, the timed 10-hour overnight effluent and blood were sampled and a peritoneal equilibration test (PET) was performed. (Abstract truncated at 2000 characters)
Vrsta gradiva - disertacija
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Založništvo in izdelava - Ljubljana : [J. Pajek], 2006
GS II 0000624496 glavno skladišče
GS II 624496 glavno skladišče
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