Medical Unit Renal Medicine, Karolinska University Hospital, and CLINTEC, Karolinska Institutet, Stockholm, Sweden.
Division of Nephrology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Clin J Am Soc Nephrol. 2024 Feb 1;19(2):224-232. doi: 10.2215/CJN.0000000000000342. Epub 2023 Oct 30.
Volume overload is common in patients treated with peritoneal dialysis (PD) and is associated with poor clinical outcome. Steady concentration PD is where a continuous glucose infusion maintains the intraperitoneal glucose concentration and as a result provides continuous ultrafiltration throughout the dwell. The primary objective of this study was to investigate the ultrafiltration rate and glucose ultrafiltration efficiency for steady concentration PD in comparison with a standard continuous ambulatory PD (CAPD) dwell, using the novel Carry Life UF device.
Eight stable patients treated with PD (six fast and two fast average transporters) were investigated four times: a standard 4-hour CAPD dwell with 2 L of 2.5% dextrose solution as control and three 5-hour steady concentration PD treatments (glucose dose 11, 14, 20 g/h, initial fill 1.5 L of 1.5% dextrose solution). All investigations were preceded by an overnight 2 L 7.5% icodextrin dwell.
Intraperitoneal glucose concentration increased during the first 1-2 hours of the steady concentration PD treatments and remained stable thereafter. Ultrafiltration rates were significantly higher with steady concentration PD treatments (124±49, 146±63, and 168±78 mL/h with 11, 14, and 20 g/h, respectively, versus 40±60 mL/h with the control dwell). Sodium removal and glucose ultrafiltration efficiency (ultrafiltration volume/gram glucose uptake) were significantly higher with steady concentration PD treatments versus the control dwell, where the 11 g/h glucose dose was most efficient.
Steady concentration PD performed with the Carry Life UF device resulted in higher ultrafiltration rates, more efficient use of glucose (increased ultrafiltration volume/gram glucose absorbed), and greater sodium removal compared with a standard 2.5% dextrose CAPD dwell.
A Performance Analysis of the Peritoneal Ultrafiltration (PUF) Achieved With the Carry Life ® UF, NCT03724682 .
腹膜透析（PD）治疗的患者常发生容量超负荷，与不良临床结局相关。持续浓度 PD 是指持续葡萄糖输注维持腹腔内葡萄糖浓度，从而在整个留腹期间持续超滤。本研究的主要目的是使用新型 Carry Life UF 装置比较持续浓度 PD 与标准连续不卧床 PD（CAPD）留腹时的超滤率和葡萄糖超滤效率。
8 例 PD 稳定患者（6 例快速和 2 例快速平均转运者）接受了 4 次研究：以 2 L 2.5%葡萄糖溶液的标准 4 小时 CAPD 留腹作为对照，以及 3 次 5 小时持续浓度 PD 治疗（葡萄糖剂量 11、14、20 g/h，初始填充 1.5 L 1.5%葡萄糖溶液）。所有研究均在隔夜 2 L 7.5%艾考糊精留腹后进行。
在持续浓度 PD 治疗的最初 1-2 小时内，腹腔内葡萄糖浓度升高，此后保持稳定。持续浓度 PD 治疗的超滤率显著更高（分别为 11、14 和 20 g/h 时为 124±49、146±63 和 168±78 mL/h，而对照留腹时为 40±60 mL/h）。与标准 2.5%葡萄糖 CAPD 留腹相比，持续浓度 PD 治疗的钠清除率和葡萄糖超滤效率（超滤量/葡萄糖摄取量）更高，其中 11 g/h 葡萄糖剂量效率最高。
与标准 2.5%葡萄糖 CAPD 留腹相比，使用 Carry Life UF 装置进行的持续浓度 PD 可导致更高的超滤率、更有效地利用葡萄糖（增加超滤量/葡萄糖摄取量）以及更大的钠清除率。
腹膜超滤（PUF）与 Carry Life ® UF 相关的性能分析，NCT03724682。
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