Kidney Week

Abstract: SU-OR23

Steady Concentration Peritoneal Dialysis Increases Ultrafiltration and Sodium Removal Compared with Continuous Ambulatory Peritoneal Dialysis (CAPD)

Session Information

• Peritoneal Dialysis and Vascular Access: Research Abstracts
  October 25, 2020 | Location: Simulive
  Abstract Time: 05:00 PM - 07:00 PM

Category: Dialysis

• 703 Dialysis: Peritoneal Dialysis

Authors

• Heimburger, Olof, CLINTECH, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

Olof Heimburger, MD, PhD



Olof Heimbürger short CV Olof Heimbürger (born 1957), MD, PhD, Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet. Senior Physician, Medical Unit Renal Medcine Karolinska University Hospital, Huddinge and Solna, Stockholm, Sweden. Ph D Thesis (1994): “Peritoneal transport in patients treated with continuous peritoneal dialysis”. I have more that 30 years of clinical nephrology experience and has published more than 350 papers and textbook chapters on peritoneal dialysis, nutrition, inflammation and cardiovascular disease in patients with chronic renal failure. I was a council member of the International Society for Peritoneal Dialysis 2001-2014 and a member of the European Renal Best Practice (ERBP, the guidline committee of ERA-EDTA) advisory board 2008-2020.

• Martus, Giedre, Department of Nephrology, Skåne University Hospital, Malmö, Sweden

Giedre Martus,

• Wilkie, Martin E., Sheffield Teaching Hospital, NHS Foundation Trust, Sheffield, United Kingdom

Martin E. Wilkie,

• Hegbrant, Jorgen BA, Department of Nephrology, Lund University, Lund, Sweden

Jorgen BA Hegbrant,

• Carlsson, Ola, Triomed AB, Lund, Sweden

Ola Carlsson,

• De Leon, Charlotte, Triomed AB, Lund, Sweden

Charlotte De Leon,

• Johansson, Ann Cathrine, Department of Nephrology, Skåne University Hospital, Malmö, Sweden

Ann Cathrine Johansson,

Background

Fluid and sodium removal (NaR) may be a challenge during glucose-based PD, leading to increased use of high glucose solutions to maintain sufficient fluid removal. This may lead to increased sodium sieving, resulting in reduced NaR. Carry Life^® UF uses steady concentration PD (SCPD), where the intraperitoneal (IP) glucose concentration is maintained by infusion of glucose to provide a continuous ultrafiltration (UF) throughout the dwell. The present study investigated the effect of Carry Life^® UF vs. CAPD regarding UF, NaR and glucose absorption.

Methods

Eight stable PD patients were included in the study. Subjects were treated with 5-hour Carry Life^® UF treatments using three different glucose doses (11, 14, 20 g/h). An initial fill with 1.5 l, 1.36% glucose PD solution was used. A small volume of dialysate was drained hourly to avoid overfill. A 4-hour peritoneal equilibration test (PET) (2.0 l, 2.27% glucose) served as control. Data expressed as mean±SD, statistical analysis using ANOVA.

Results

UF volumes were significantly increased during Carry Life^® UF treatments (646±256, 739±312, 863±380 ml for 11, 14 and 20 g/h) vs. PET (162±242 ml, p<0.01). NaR increased significantly during Carry Life^® UF treatments (86±27, 92±33 110±37 mmol/dwell for 11, 14 and 20 g glucose/h) compared to PET (22±33 mmol/dwell, p<0.001).

Conclusion

SCPD performed with Carry Life^® UF maintained a stable IP glucose concentration during the treatment (figure a) which generated significantly higher UF volumes compared to PET. During the Carry Life UF treatments glucose was used more efficiently, particularly for the two lowest doses, in comparison to PET (figure b). In summary, SCPD using Carry Life^® UF increases the efficiency of PD compared to standard, glucose-based CAPD with respect to UF and NaR.

IP glucose concentration in g/l during treatments (a).
UF efficiency expressed as UF volume in ml per gram of glucose absorbed during treatments, *p<0.05, **p<0.01 (b).

Funding

• Commercial Support – Triomed AB