Posthuma N, ter Weel P M, Donker A J, Peers E M, Oe P L, Verbrugh H A
Department of Nephrology, University Hospital Vrije Universiteit Amsterdam, The Netherlands.
Nephrol Dial Transplant. 1998 Sep;13(9):2341-4. doi: 10.1093/ndt/13.9.2341.
In a randomized study on the biocompatibility of icodextrin (I) versus glucose (G) in CCPD we used icodextrin or glucose for the long daytime dwell. During the night-time dwells glucose was used in all patients. In case of peritonitis icodextrin was continued. In all patients ultrafiltration (UF) was recorded and serum icodextrin metabolites were determined every 3 months and during peritonitis in I-users when available.
Thirty-eight patients ( 19 G, 19 I) entered the study and suffered 30 peritonitis episodes (16 G, 14 I). During peritonitis (P), daytime dwell UF decreased significantly in G (P=0.001), but remained stable in I patients compared to non-peritonitis (NP) episodes. Total 24-h UF decreased in G (P=0.001) and in I patients (P=0.04), as the result of a decreased daytime UF and night-time UF, respectively. There was no difference in the used glucose concentrations during the P versus NP episodes. In five I-patients serum disaccharides increased from 0.05+/-0.01 to 1.26+/-0.23mg/ml during follow up. During peritonitis serum disaccharide concentrations did not increase further (1.47+/-0.24 mg/ml, P= 0.56). In I patients total carbohydrate minus glucose rose to 5.72 +/- 1.2 mg/ml during follow up, and to 6.63 +/- 1.04 mg/ml during peritonitis (P=0.7). These concentrations are comparable to CAPD patients despite the longer dwelltime in CCPD (8-10 versus 14-16 h, respectively). Adverse reactions attributable to icodextrin were not encountered.
In contrast to glucose, icodextrin preserved the daytime dwell ultrafiltration during peritonitis. Serum icodextrin metabolites increased during icodextrin use, but remained stable during peritonitis. Adverse effects were not observed.
在一项关于间歇性腹膜透析（CCPD）中艾考糊精（I）与葡萄糖（G）生物相容性的随机研究中，我们在日间长时间留腹时使用艾考糊精或葡萄糖。在夜间留腹时，所有患者均使用葡萄糖。发生腹膜炎时，继续使用艾考糊精。记录所有患者的超滤量（UF），每3个月测定一次使用艾考糊精患者的血清艾考糊精代谢产物，腹膜炎发作时如有可能也进行测定。
38例患者（19例使用葡萄糖，19例使用艾考糊精）进入研究，共发生30次腹膜炎发作（16次使用葡萄糖，14次使用艾考糊精）。在腹膜炎（P）期间，使用葡萄糖的患者日间留腹超滤量显著下降（P = 0.001），而与非腹膜炎（NP）发作相比，使用艾考糊精的患者超滤量保持稳定。由于日间和夜间超滤量分别下降，使用葡萄糖的患者24小时总超滤量下降（P = 0.001），使用艾考糊精的患者也下降（P = 0.04）。腹膜炎发作与非腹膜炎发作期间使用的葡萄糖浓度无差异。在5例使用艾考糊精的患者中，随访期间血清二糖从0.05±0.01mg/ml增加至1.26±0.23mg/ml。腹膜炎发作期间血清二糖浓度未进一步升高（1.47±0.24mg/ml，P = 0.56）。在使用艾考糊精的患者中，随访期间总碳水化合物减去葡萄糖升至5.72±1.2mg/ml，腹膜炎发作时升至6.63±1.04mg/ml（P = 0.7）。尽管CCPD的留腹时间更长（分别为8 - 10小时和14 - 16小时），但这些浓度与持续性非卧床腹膜透析（CAPD）患者相当。未遇到与艾考糊精相关的不良反应。
与葡萄糖不同，艾考糊精在腹膜炎期间可保持日间留腹超滤量。使用艾考糊精期间血清艾考糊精代谢产物增加，但在腹膜炎期间保持稳定。未观察到不良反应。
