使用艾考糊精和氨基酸腹膜透析液时，驻留时间对羰基应激的影响。

Effect of dwell time on carbonyl stress using icodextrin and amino acid peritoneal dialysis fluids.

作者信息

Ueda Y, Miyata T, Goffin E, Yoshino A, Inagi R, Ishibashi Y, Izuhara Y, Saito A, Kurokawa K, Van Ypersele De Strihou C

机构信息

Molecular and Cellular Nephrology, Institute of Medical Sciences and Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan.

出版信息

Kidney Int. 2000 Dec;58(6):2518-24. doi: 10.1046/j.1523-1755.2000.00436.x.

DOI:10.1046/j.1523-1755.2000.00436.x

PMID:11115086

Abstract

BACKGROUND

Deterioration of the peritoneal membrane limits the technical survival of peritoneal dialysis (PD). Advanced glycation of the membrane has been incriminated in this evolution. Advanced glycation end products (AGEs) develop under the influence of glucose and of its degradation products, mainly reactive carbonyl compounds (RCOs) such as glyoxal (GO), methylglyoxal (MGO), and 3-deoxyglucosone (3-DG). The present study was undertaken to evaluate the impact of recently developed glucose-free PD fluids on AGE generation.

METHODS

Recently developed glucose-free PD fluids containing either icodextrin or amino acids were investigated. GO, MGO, and 3-DG [high-performance liquid chromatography (HPLC)] and total RCOs (spectrophotometry) were measured in fresh solutions and in effluents after various dwell duration. The AGE formation potential of PD fluids and effluents was assessed by incubation at 37 degrees C, for one week, with bovine serum albumin and by the eventual measurement of pentosidine (HPLC) and Nepsilon-carboxymethyllysine (CML; gas chromatography/mass spectrometry).

RESULTS

GO, MGO, and 3-DG (P < 0. 001) as well as total RCOs levels (P < 0.01) were significantly lower in icodextrin and amino acid PD fluid than in commercial, heat-sterilized, 1.36% glucose PD fluid. Pentosidine and CML generation were also significantly lower (P < 0.001) in icodextrin and amino acid PD fluid than in conventional 1.36% glucose PD fluid. The levels of total RCOs, however, increased in icodextrin and amino acid PD fluid effluents with dwell time. AGE formation potential rose accordingly, as demonstrated by a parallel increase in the generation of pentosidine and CML during incubation of PD effluents.

CONCLUSION

The present data demonstrate lower RCO contents and AGE formation potential in fresh icodextrin and amino acid PD fluids than in fresh heat-sterilized glucose PD fluids. However, this difference decreases progressively during dwell time, mainly as a result of the influx of total RCOs.

摘要

背景

腹膜的退变限制了腹膜透析（PD）的技术生存时间。膜的晚期糖基化被认为参与了这一进程。晚期糖基化终产物（AGEs）在葡萄糖及其降解产物的影响下形成，主要是活性羰基化合物（RCOs），如乙二醛（GO）、甲基乙二醛（MGO）和3-脱氧葡萄糖酮（3-DG）。本研究旨在评估最近开发的无糖腹膜透析液对AGE生成的影响。

方法

研究了最近开发的含有艾考糊精或氨基酸的无糖腹膜透析液。通过高效液相色谱法（HPLC）测定新鲜溶液和不同驻留时间后的流出液中的GO、MGO和3-DG，并通过分光光度法测定总RCOs。通过在37℃下与牛血清白蛋白孵育一周，并最终测定戊糖苷（HPLC）和Nε-羧甲基赖氨酸（CML；气相色谱/质谱法）来评估腹膜透析液和流出液的AGE形成潜力。

结果

艾考糊精和氨基酸腹膜透析液中的GO、MGO和3-DG（P < 0.001）以及总RCOs水平（P < 0.01）显著低于市售的热灭菌1.36%葡萄糖腹膜透析液。艾考糊精和氨基酸腹膜透析液中的戊糖苷和CML生成也显著低于传统的1.36%葡萄糖腹膜透析液（P < 0.001）。然而，艾考糊精和氨基酸腹膜透析液流出液中的总RCOs水平随驻留时间增加。如腹膜透析流出液孵育期间戊糖苷和CML生成的平行增加所示，AGE形成潜力相应增加。