de Boer A W, Schröder C H, van Vliet R, Willems J L, Monnens L A
Department of Pediatrics, University Hospital Nijmegen, The Netherlands.
Pediatr Nephrol. 2000 Nov;15(1-2):21-4. doi: 10.1007/s004670000406.
Icodextrin use in adults provides sustained ultrafiltration (UF) in long-term dwells. No information is available on UF and metabolism in children. In 11 children, a volume of 1,049+/-138 ml/m2 of the study fluid (1.36% glucose, 7.5% icodextrin, 3.86% glucose) was administered for 12 h. Net UF with icodextrin (339+/-147 ml/1.73 m2) did not differ from UF with 3.86% glucose (450+/-306 ml/1.73 m2, P=0.53) and was higher than UF with 1.36% glucose (-87+/-239 ml/1.73 m2, P=0.003). Icodextrin added 0.52+/-0.07 to the weekly Kt/V. Over 6 weeks, icodextrin was used for 12-h daytime dwell. Total icodextrin reached a steady-state level of 2.91+/-1.22 g/l at 2 weeks. The main icodextrin metabolites were maltose, maltotriose, and maltotetraose. After 2 weeks, steady state levels were 2.02+/-0.66 mmol/l, 1.46+/-0.35 mmol/l, and 0.45+/-0.12 mmol/l. No icodextrin or metabolites were detectable 4 weeks after the study. We conclude that 7.5% icodextrin is capable of maintaining UF during 12-h dwell in children and is comparable to UF obtained with 3.86% glucose. Steady-state levels of icodextrin and metabolites were reached at 2 weeks and disappeared after the study.
成人使用艾考糊精在长期留腹时可提供持续超滤。目前尚无关于儿童超滤及代谢情况的信息。在11名儿童中，给予每平方米体表面积1,049±138毫升的研究液（1.36%葡萄糖、7.5%艾考糊精、3.86%葡萄糖），持续12小时。使用艾考糊精时的净超滤量（339±147毫升/1.73平方米）与使用3.86%葡萄糖时的超滤量（450±306毫升/1.73平方米，P = 0.53）无差异，且高于使用1.36%葡萄糖时的超滤量（-87±239毫升/1.73平方米，P = 0.003）。艾考糊精使每周的Kt/V增加0.52±0.07。在6周时间里，艾考糊精用于白天12小时留腹。2周时艾考糊精总量达到稳态水平2.91±1.22克/升。艾考糊精的主要代谢产物为麦芽糖、麦芽三糖和麦芽四糖。2周后，稳态水平分别为2.02±0.66毫摩尔/升、1.46±0.35毫摩尔/升和0.45±0.12毫摩尔/升。研究结束4周后未检测到艾考糊精或其代谢产物。我们得出结论，7.5%艾考糊精能够在儿童12小时留腹期间维持超滤，且与3.86%葡萄糖获得的超滤效果相当。艾考糊精及其代谢产物在2周时达到稳态水平，研究结束后消失。
