The benefits of peritoneal dialysis (PD) solution with low-glucose degradation product in residual renal function and dialysis adequacy in PD patients: A meta-analysis.

Beneficios de la solución de diálisis peritoneal (DP), con producto de degradación bajo en glucosa, en la función renal residual y la adecuación de la diálisis en pacientes en DP: un metanálisis.

  • Sheng Chen Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.
  • Jieshuang Jia Shanghai General Hospital, Shanghai, China.
  • Huimin Guo Shandong First Medical University, Jinan, Shandong, China.
  • Nan Zhu Shanghai General Hospital, Shanghai, China.
Palabras clave: productos de degradación de glucosa, solución de diálisis peritoneal, función renal residual, adecuación de diálisis, metanálisis

Resumen

Los efectos peritoneales de las soluciones de diálisis peritoneal (DP) que contienen productos de degradación bajos en glucosa (PIB) se han descrito ampliamente. Para evaluar sistemáticamente la eficacia y la seguridad de la solución de PIB bajo para pacientes en DP, específicamente el efecto sobre la función renal residual (RRF) y la adecuación de la diálisis, realizamos un metanálisis de los ensayos controlados aleatorios (ECA) publicados. Se realizaron búsquedas en diferentes bases de datos de ECA que compararan la solución de DP de bajo PIB con la solución de DP convencional en el tratamiento de pacientes con EP con CAPD y APD. Los resultados de los ECA deben incluir la RRF y pueden incluir la depuración de solutos pequeños, el estado nutricional, el estado del transporte peritoneal y la mortalidad por todas las causas. Se incluyeron siete estudios (632 pacientes). En comparación con la solución convencional, la solución de bajo PIB preservó la FRR en pacientes con EP a lo largo del tiempo (DM 0,66 mL/min, IC del 95%: 0,34 a 0,99; p<0,0001), particularmente en un año de tratamiento (p<0,01), y mejoró el Kt/V semanal (DM 0,11, IC del 95%: 0,05 a 0,17; p = 0,0007), sin un aumento de D/Pcr a las 4 horas (DM 0,00, IC del 95%: -0,02 a 0,02; p = 1,00). Los pacientes que usaron una solución para DP con bajo contenido de GDP no tuvieron un mayor riesgo de mortalidad por todas las causas (DM 0,97; IC del 95%: 0,50 a 1,88; p =0,93). Nuestro metanálisis confirma que la solución de DP de bajo PIB preserva la FRR, mejora la adecuación de la diálisis sin aumentar la tasa de transporte peritoneal de solutos y la mortalidad por todas las causas. Se necesitan más ensayos para determinar si este efecto beneficioso puede afectar los resultados clínicos a largo plazo.

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Biografía del autor/a

Sheng Chen, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.

Department of Nephrology, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.

Jieshuang Jia, Shanghai General Hospital, Shanghai, China.

Department of Nephrology, Shanghai General Hospital, Shanghai, China.

Huimin Guo, Shandong First Medical University, Jinan, Shandong, China.

Department of Nuclear Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.

Nan Zhu, Shanghai General Hospital, Shanghai, China.

Department of Nephrology, Shanghai General Hospital, Shanghai, China.

Citas

Krediet RT. 30 years of peritoneal dialysis development: The past and the future. Perit Dial Int 2007;27 Suppl 2:S35-41.

Jain AK, Blake P, Cordy P, Garg AX. Global trends in rates of peritoneal dialysis. J Am Soc Nephrol 2012;23:533-544.

Johnson DW, Brown FG, Clarke M, Boudville N, Elias TJ, Foo MW, Jones B, Kulkarni H, Langham R, Ranganathan D, Schollum J, Suranyi M, Tan SH, Voss D. Effects of biocompatible versus standard fluid on peritoneal dialysis outcomes. J Am Soc Nephrol 2012;23:1097-1107.

Rumpsfeld M, McDonald SP, Johnson DW. Peritoneal small solute clearance is nonlinearly related to patient survival in the Australian and New Zealand peritoneal dialysis patient populations. Perit Dial Int 2009;29:637-646

Tam P. Peritoneal dialysis and preservation of residual renal function. Perit Dial Int. 2009;29 Suppl 2:S108-110.

Cho Y, Badve SV, Hawley CM, Wiggins K, Johnson DW. Biocompatible peritoneal dialysis fluids: Clinical outcomes. Int J Nephrol 2012;2012:812609.

Termorshuizen F, Korevaar JC, Dekker FW, van Manen JG, Boeschoten EW, Krediet RT. The relative importance of residual renal function compared with peritoneal clearance for patient survival and quality of life: An analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NE- COSAD )-2. Am J Kidney Dis 2003;41:1293- 1302.

Wang AY. The “heart” of peritoneal dialysis. Perit Dial Int 2007;27 Suppl 2:S228-232.

Diaz-Buxo J, Clark SC, Ho CH, Jensen LE. New pH-neutral peritoneal dialysis solution, low in glucose degradation products, in a double-chamber bag. Adv Perit Dial 2010;26:28-32.

Wieslander A, Linden T. Glucose degradation and cytotoxicity in pd fluids. Perit Dial Int 1996;16 Suppl 1:S114-118.

Chan TM, Yung S. Studying the effects of new peritoneal dialysis solutions on the peritoneum. Perit Dial Int 2007;27 Suppl 2:S87-93.

Witowski J, Bender TO, Gahl GM, Frei U, Jorres A. Glucose degradation products and peritoneal membrane function. Perit Dial Int 2001;21:201-205.

Plum J, Lordnejad MR, Grabensee B. Effect of alternative peritoneal dialysis solutions on cell viability, apoptosis/necrosis and cytokine expression in human monocytes. Kidney Int 1998;54:224-235.

Williams JD, Topley N, Craig KJ, Mackenzie RK, Pischetsrieder M, Lage C, Passlick-Deetjen J. The euro-balance trial: The effect of a new biocompatible peritoneal dialysis fluid (balance) on the peritoneal membrane. Kidney Int 2004;66:408-418.

Szeto CC, Chow KM, Lam CW, Leung CB, Kwan BC, Chung KY, Law MC, Li PK. Clinical biocompatibility of a neutral peritoneal dialysis solution with minimal glucose-degradation products--a 1-year randomized control trial. Nephrol Dial Transplant 2007;22:552-559.

Fan SL, Pile T, Punzalan S, Raftery MJ, Yaqoob MM. Randomized controlled study of biocompatible peritoneal dialysis solutions: Effect on residual renal function. Kidney Int 2008;73:200-206.

Park SH, Do JY, Kim YH, Lee HY, Kim BS, Shin SK, Kim HC, Chang YK, Yang JO, Chung HC, Kim CD, Lee WK, Kim JY, Kim YL. Effects of neutral pH and low-glucose degradation product-containing peritoneal dialysis fluid on systemic markers of inflammation and endothelial dysfunction: A randomized controlled 1-year follow-up study. Nephrol Dial Transplant 2012;27:1191- 1199.

Justo P, Sanz AB, Egido J, Ortiz A. 3,4-di- deoxyglucosone-3-ene induces apoptosis in renal tubular epithelial cells. Diabetes 2005;54:2424-2429.

Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Controlled clinical trials 1996;17:1-12.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The prisma statement. Ann Intern Med 2009;151:264-269.

Choi HY, Kim DK, Lee TH, Moon SJ, Han SH, Lee JE, Kim BS, Park HC, Choi KH, Ha SK, Han DS, Lee HY. The clinical usefulness of peritoneal dialysis fluids with neutral ph and low glucose degradation product concentration: An open randomized prospective trial. Perit Dial Int 2008;28:174-182.

Kim YL, Do J, Park SH, Cho K, Park J, Yoon K, Cho DK, Lee EG, Kim IS. Low glucose degradation products dialysis solution modulates the levels of surrogate markers of peritoneal inflammation, integrity, and angiogenesis: Preliminary report. Nephro- logy (Carlton) 2003;8 Suppl:S28-32.

Kim SG, Kim S, Hwang Y-H, Kim K, Oh JE, Chung W, Oh K-H, Kim HJ, Ahn C. Could solutions low in glucose degradation products preserve residual renal function in incident peritoneal dialysis patients? A 1-year multicenter prospective randomized controlled trial (balnet study). Perit Dial Int 2008;28:S117-S122.

Bajo MA, Pérez-Lozano ML, Albar-Vizcaino P, del Peso G, Castro M-J, Gonzalez- Mateo G, Fernández-Perpén A, Aguilera A, Sánchez-Villanueva R, Sánchez-Tomero JA. Low-gdp peritoneal dialysis fluid (‘balance’) has less impact in vitro and ex vivo on epithelial-to-mesenchymal transition (emt) of mesothelial cells than a standard fluid. Nephrol Dial Transplant 2011;26:282-291

Mujais S, Nolph K, Gokal R, Blake P, Burkart J, Coles G, Kawaguchi Y, Kawanishi H, Korbet S, Krediet R, Lindholm B, Oreopoulos D, Rippe B, Selgas R. Evaluation and management of ultrafiltration problems in peritoneal dialysis. International society for peritoneal dialysis ad hoc committee on ultrafiltration management in peritoneal dialysis. Perit Dial Int 2000;20 Suppl 4:S5-21.

Piraino B, Bernardini J, Brown E, Figueiredo A, Johnson DW, Lye WC, Price V, Ramalakshmi S, Szeto CC. Ispd position statement on reducing the risks of peritoneal dialysis-related infections. Perit Dial Int 2011;31:614-630

Kim S, Oh J, Chung W, Ahn C, Kim SG, Oh KH. Benefits of biocompatible pd fluid for preservation of residual renal function in incident capd patients: A 1-year study. Nephrol Dial Transplant 2009;24:2899-2908.

Bargman JM, Thorpe KE, Churchill DN. Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis: A reanalysis of the canusa study. J Am Soc Nephrol 2001;12:2158- 2162.

Haag-Weber M, Kramer R, Haake R, Islam MS, Prischl F, Haug U, Nabut JL, Deppisch R. Low-gdp fluid (gambrosol trio) attenuates decline of residual renal function in pd patients: A prospective randomized study. Nephrol Dial Transplant 2010;25:2288- 2296.

Tranaeus A. A long-term study of a bicar- bonate/lactate-based peritoneal dialysis solution--clinical benefits. The bicarbo- nate/lactate study group. Perit Dial Int 2000;20:516-523.

McDonald S, Hurst K. Thirty fourth annual report. Australian & New Zealand Dialysis & Transplant Registry Report. Adelaide, South Australia. 2011.

Konings CJ, Kooman JP, Schonck M, Gladziwa U, Wirtz J, Bake AWVDW, Gerlag PG, Hoorntje SJ, Wolters J, Van Der Sande FM. Effect of icodextrin on volume status, blood pressure and echocardiographic parameters: A randomized study. Kidney Int 2003;63:1556-1563.

Konings CJ, Kooman JP, Gladziwa U, van der Sande FM, Leunissen KM. A decline in residual glomerular filtration during the use of icodextrin may be due to underhydration. Kidney Int 2005;67:1190-1191.

Cho Y, Johnson DW, Craig JC, Strippoli GF, Badve SV, Wiggins KJ. Biocompatible dialysis fluids for peritoneal dialysis. Cochrane Database Syst Rev 2014;3:CD007554.

Davies SJ, Phillips L, Russell GI. Peritoneal solute transport predicts survival on capd independently of residual renal function. Nephrol Dial Transplant 1998;13:962-968.

Chung SH, Lindholm B, Lee HB. Influence of initial nutritional status on continuous ambulatory peritoneal dialysis patient survival. Perit Dial Int 2000;20:19-26.

Cho Y, Johnson DW, Badve SV, Craig JC, Strippoli GF, Wiggins KJ. The impact of neutral-pH peritoneal dialysates with reduced glucose degradation products on clinical outcomes in peritoneal dialysis patients. Kidney Int 2013;84:969-979.

Lee HY, Park HC, Seo BJ, Do JY, Yun SR, Song HY, Kim YH, Kim YL, Kim DJ, Kim YS, Ahn C, Kim MJ, Shin SK. Superior patient survival for continuous ambulatory peritoneal dialysis patients treated with a peritoneal dialysis fluid with neutral ph and low glucose degradation product concentration (balance). Perit Dial Int 2005;25:248-255.

Lee HY, Choi HY, Park HC, Seo BJ, Do JY, Yun SR, Song HY, Kim YH, Kim YL, Kim DJ, Kim YS, Kim MJ, Shin SK. Changing prescribing practice in capd patients in korea: Increased utilization of low gdp solutions improves patient outcome. Nephrol Dial Transplant 2006;21:2893-2899.

Htay H, Johnson DW, Wiggins KJ, Badve SV, Craig JC, Strippoli GF, Cho Y. Bio-compatible dialysis fluids for peritoneal dialysis. Cochrane Database Syst Rev 2018; 26:10(10).
Publicado
2022-08-23
Cómo citar
Chen, S., Jia, J., Guo, H., & Zhu, N. (2022). The benefits of peritoneal dialysis (PD) solution with low-glucose degradation product in residual renal function and dialysis adequacy in PD patients: A meta-analysis.: Beneficios de la solución de diálisis peritoneal (DP), con producto de degradación bajo en glucosa, en la función renal residual y la adecuación de la diálisis en pacientes en DP: un metanálisis. Investigación Clínica, 63(3), 283-303. https://doi.org/10.54817/IC.v63n3a07