Optimal use of peritoneal dialysis fluids in type 2 diabetes mellitus patients

The glucose side-effects, the main osmotic agent in conventional peritoneal dialysis (PD) solutions, are structural and functional changes of the peritoneal membrane, especially diabetic alterations in the microvasculature. Therefore, hyperpermeability with high small solutes transport and less ultr...

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Bibliographic Details
Published in:Néphrologie & thérapeutique Vol. 2 Suppl 1; p. S82
Main Authors: Ryckelynck, Jean-Philippe, Allard, Catherine, Cousin, Maud, Hurault de Ligny, Bruno, El Haggan, Wael, Lobbedez, Thierry
Format: Journal Article
Language:French
Published: France 01.01.2006
Subjects:
Diabetes Mellitus, Type 2 - complications
Diabetic Nephropathies - etiology
Diabetic Nephropathies - therapy
Dialysis Solutions
Humans
Peritoneal Dialysis - methods
ISSN:1769-7255
Online Access:Get full text
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Summary:The glucose side-effects, the main osmotic agent in conventional peritoneal dialysis (PD) solutions, are structural and functional changes of the peritoneal membrane, especially diabetic alterations in the microvasculature. Therefore, hyperpermeability with high small solutes transport and less ultrafiltration necessitates more and more high glucose concentration solutions. Glucose degradation products (PDF) and advanced glycation end-products (AGE) are formed and may induce peritoneal membrane alterations. More biocompatible solutions have to be used with less PDF and physiological pH. Icodextrin containing PD solutions have beneficial effect on sustained ultrafiltration for long dwells in PD, limitating fluid overload common in PD patients above all during peritonitis episodes. Amino acid-based PD solutions contribute to the prevention of malnutrition often observed in the diabetic PD population.
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ISSN:1769-7255