Abstract:
BACKGROUND:Although peritoneal dialysis (PD) is a widely accepted form of renal replacement therapy (RRT), concerns remain regarding the bioincompatible nature of standard PD fluid. In order to evaluate whether a newly formulated fluid of neutral pH, and containing low levels of glucose degradation products (GDP), resulted in improved in vivo biocompatibility, it was compared in a clinical study to a standard PD fluid. METHODS:In a multicenter, open, randomized, prospective study with a crossover design and parallel arms, a conventional, acidic, lactate-buffered fluid (SPDF) was compared with a pH neutral, lactate-buffered, low GDP fluid (balance). Overnight effluent was collected and assayed for cancer antigen 125 (CA125), hyaluronic acid (HA), procollagen peptide (PICP), vascular endothelial growth factor (VEGF), and tumor necrosis factor alpha (TNFalpha). Serum samples were assayed for circulating advanced glycosylation end products (AGE), N(epsilon)-(carboxymethyl)lysine (CML), and imidazolone. Clinical end points were residual renal function (RRF), adequacy of dialysis, ultrafiltration, and peritoneal membrane function. Eighty-six patients were randomized to either group I starting with SPDF for 12 weeks (Phase I), then switching to "balance" for 12 weeks (Phase II), or group II, which was treated vice versa. Seventy-one patients completed the study with data suitable for entry into the per protocol analysis. Effluent and serum samples, together with peritoneal function tests and adequacy measurements, were undertaken at study centers on three occasions during the study: after the four-week run-in period, after Phase I, and again after Phase II. RESULTS:In patients treated with balance there were significantly higher effluent levels of CA125 and PICP in both arms of the study. Conversely, levels of HA were lower in patients exposed to balance, while there was no change in the levels of either VEGF or TNFalpha. Serum CML and imidazolone levels fell significantly in balance-treated patients. Renal urea and creatinine clearances were higher in both treatment arms after patients were exposed to balance. Urine volume was higher in patients exposed to balance. In contrast, peritoneal ultrafiltration was higher in patients on SPDF. When anuric patients were analyzed as a subgroup, there was no significant difference in peritoneal transport characteristics or in ultrafiltration on either fluid. There were no changes in peritonitis incidence on either solution. CONCLUSION:This study indicates that the use of balance, a neutral pH, low GDP fluid, is accompanied by a significant improvement in effluent markers of peritoneal membrane integrity and significantly decreased circulating AGE levels. Clinical parameters suggest an improvement in residual renal function on balance, with an accompanying decrease in peritoneal ultrafiltration. It would appear that balance solution results in an improvement in local peritoneal homeostasis, as well as having a positive impact on systemic parameters, including circulating AGE and residual renal function.
journal_name
Kidney Intjournal_title
Kidney internationalauthors
Williams JD,Topley N,Craig KJ,Mackenzie RK,Pischetsrieder M,Lage C,Passlick-Deetjen J,Euro Balance Trial Group.doi
10.1111/j.1523-1755.2004.00747.xsubject
Has Abstractpub_date
2004-07-01 00:00:00pages
408-18issue
1eissn
0085-2538issn
1523-1755pii
S0085-2538(15)50044-6journal_volume
66pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract::The antiphospholipid syndrome is a common autoimmune disease caused by pathogenic antiphospholipid antibodies, leading to recurrent thrombosis and/or obstetrical complications. Importantly for nephrologists, antiphospholipid antibodies are associated with various renal manifestations including large renal vessel throm...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1016/j.kint.2016.06.026
更新日期:2017-01-01 00:00:00
abstract::The subcellular distribution of immunoreactive kallikrein was described in the rat nephron using ultrastructural immunocytochemistry. The renal tissue was fixed with a mixture of buffered picric acid-paraformaldehyde-glutaraldehyde and immunostained with the peroxidase-antiperoxidase method for the electron microscope...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1985.115
更新日期:1985-07-01 00:00:00
abstract::Experimental unilateral ureteral obstruction (UUO) is widely used to study renal fibrosis; however, renal injury can only be scored semiobjectively by histology. We sought to improve the UUO model by reimplanting the obstructed ureter followed by removal of the contralateral kidney, thus allowing longitudinal measurem...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/sj.ki.5002797
更新日期:2008-04-01 00:00:00
abstract::Early graft loss (EGL) is a feared outcome of kidney transplantation. Consequently, kidneys with an anticipated risk of EGL are declined for transplantation. In the most favorable scenario, with optimal use of available donor kidneys, the donor pool size is balanced by the risk of EGL, with a tradeoff dictated by the ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2020.01.043
更新日期:2020-06-01 00:00:00
abstract::Administration of antibody, directed against glomerular basement membrane (GBM) heparan sulfate-proteoglycan, into a presensitized rat results in the induction of membranous nephropathy with subepithelial immune-complex deposits. In this investigation, we examined the mechanisms responsible for the formation of subepi...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1988.166
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:We have recently demonstrated an increase in apoptosis in Han:SPRD rat kidneys with autosomal-dominant polycystic kidney disease (ADPKD). Caspase-3 and caspase-7 are major mediators of apoptosis. There are two pathways of caspase-3 and caspase-7-mediated apoptosis: (1) the "extrinsic" pathway involving the d...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2005.00155.x
更新日期:2005-03-01 00:00:00
abstract::Residual renal function is a major survival determinant for peritoneal dialysis patients. Hypovolemia can cause acute kidney injury and loss of residual renal function, and it has been suggested that patients receiving peritoneal dialysis should preferably be maintained hypervolemic to preserve residual renal function...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2013.273
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:It is currently impossible to reliably predict which diabetic patients will develop nephropathy and progress to kidney failure. Microalbuminuria, often regarded as a predictor of overt diabetic renal disease is, in fact, an indicator of established glomerular damage. We have shown that glomerular expression ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2003.00130.x
更新日期:2003-08-01 00:00:00
abstract::A major problem in cyclosporine A (CsA) therapy is its nephrotoxicity, characterized by a marked fall in glomerular filtration rate (GFR). Since the glomerular ultrafiltration area is an important determinant of GFR and has been proposed to be regulated by mesangial (MS) cell contraction, we examined the effect of CsA...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1988.149
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Hypertriglyceridemia is a result of reduced triglyceride (TG)-rich lipoprotein (TRL) catabolism and occurs in rats with nephrotic syndrome (NS) and in Nagase analbuminemic rats (NARs). While the heparin-releasable lipoprotein lipase (LpL) pool in NAR and in NS is similar, TG levels are significantly greater ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2001.00478.x
更新日期:2001-01-01 00:00:00
abstract::The OSCAR study was a multicenter, prospective randomized open-label blinded end-point study of 1164 Japanese elderly hypertensive patients comparing the efficacy of angiotensin II receptor blocker (ARB) uptitration to an ARB plus calcium channel blocker (CCB) combination. In this prospective study, we performed presp...
journal_title:Kidney international
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1038/ki.2012.326
更新日期:2013-01-01 00:00:00
abstract::In summary, it is evident that malnutrition is highly prevalent in ESRD patients. This is clearly related to multiple factors encountered during the pre-dialysis stage, as well as during maintenance dialysis therapy. A body of evidence highlights the existence of relationship between malnutrition and outcome in this p...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1038/ki.1996.323
更新日期:1996-08-01 00:00:00
abstract::Migration of monocytes into the vessel wall contributes to the onset and progression of atherosclerosis. Because monocytes are a heterogeneous population, we determined potential associations between monocyte subsets and cardiovascular events in a prospective cohort of 94 dialysis patients followed for 35 months. The ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/sj.ki.5002744
更新日期:2008-03-01 00:00:00
abstract::Vascular sclerosis is often seen in renal biopsies. It is usually associated with diabetes mellitus, hypertension, smoking, etc. However, whether inherited thrombophilic states such as factor V gene mutation, prothrombin gene mutation, and methylenetetrahydrofolate reductase (MTHFR) gene mutation are associated with t...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/sj.ki.5001551
更新日期:2006-08-01 00:00:00
abstract::Both single-frequency bioimpedance and multiple-frequency spectroscopy are equally accurate in measuring total-body water and intracellular fluid. Estimates are consistent at a population level but not at the individual level, because of wide limits of agreement. There is no real 'gold standard' method providing estim...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2013.434
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:An Experimental model of proliferative glomerulonephritis induced by an antibody against Thy-1 antigen has been established. However, the pathophysiologic role and the critical epitope of Thy-1 molecule for induction of mesangial cell dysfunction remain unknown. We have reported that monoclonal antibody 1-22...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2004.66011.x
更新日期:2004-12-01 00:00:00
abstract::Sirtuin 6 (SIRT6) is a NAD+-dependent deacetylase associated with numerous aspects of health and physiology. Overexpression of SIRT6 has emerged as a protector in cardiac tissues against pathologic cardiac hypertrophy. However, the mechanism of this protective effect is not fully understood. Here, both in vivo and in ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2017.10.021
更新日期:2018-04-01 00:00:00
abstract::Renal sodium reabsorption is a key determinant of final urine concentration. Our aim was to determine whether differences existed between aged and young rats in their response to water restriction with regard to the regulation of abundance of any of the major distal renal sodium transporter proteins. Male Fisher 344 x...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/sj.ki.5000076
更新日期:2006-01-01 00:00:00
abstract::The erythropoietin analogs have been an important advance for the treatment of the anemia of kidney disease, resulting in reduced need for blood transfusion and improved quality of life. Recent studies, however, have indicated risks associated with targeting higher levels of hemoglobin (Hb). As a result, in March 2007...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1038/sj.ki.5002401
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Dopamine (DA) is thought to regulate renal proximal transport through the inhibition of the Na+,K+-ATPase and/or Na+/H+ exchanger. Defects in this dopaminergic system are proposed to be a pathogenic factor of genetic hypertension. However, microperfusion studies have not consistently confirmed direct tubular...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2000.00873.x
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Nitric oxide inactivation by superoxide impairs endothelium-dependent vasodilation and plays a role in various forms of hypertension. Almost no data exist regarding hypertension secondary to chronic renal failure. Previous studies have shown that endothelium-related relaxations, secondary to decreased nitric...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2002.00166.x
更新日期:2002-02-01 00:00:00
abstract::Protein energy wasting is a common feature of patients with chronic kidney disease (CKD) and is associated with poor outcomes. Protein energy wasting and cachexia, a severe form of protein energy wasting, are characterized by increased resting energy expenditure but the underlying mechanisms are unclear. Browning corr...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2020.03.027
更新日期:2020-09-01 00:00:00
abstract::Fatal vascular access hemorrhage is considered a rare complication of hemodialysis (HD). Ellingson et al. indicate otherwise, and their data suggest that it causes 0.4-1.6% of deaths in US HD patients. It is more common with grafts than fistulas, and many victims have had previous access hemorrhages. The widespread pr...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2012.181
更新日期:2012-09-01 00:00:00
abstract::These studies were undertaken to examine effects of elevated glucose levels on glycolysis, sorbitol pathway activity, and the cytosolic redox state of NADH/NAD+ in isolated glomeruli. Blood-free glomeruli were isolated from kidneys of male, Sprague-Dawley rats using standard sieving techniques, then incubated for one ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1992.121
更新日期:1992-04-01 00:00:00
abstract::Females across their lifespan and certain male populations are susceptible to urinary tract infections (UTI). The influence of female vs. male sex on UTI is incompletely understood, in part because preclinical modeling has been performed almost exclusively in female mice. Here, we employed established and new mouse mo...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2018.04.023
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Renal failure and toxic acute tubular necrosis (ATN) may be seen following exposure to a variety of therapeutic agents. Zoledronate (Zometa) is a new, highly potent bisphosphonate used in the treatment of hypercalcemia of malignancy. We report the first clinical-pathologic study of nephrotoxicity associated ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2003.00071.x
更新日期:2003-07-01 00:00:00
abstract::Atherogenic lipoproteins and reactive oxygen species stimulate renin release from isolated juxtaglomerular (JG) cells. Here we assessed whether stimulation of renin release is mediated by formation of superoxide anion (O2-), and whether the effects of oxidized lipoproteins, like in many other biological systems, can b...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1997.30
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:This study examined the effects of stent placement for renal artery stenosis on the function of treated and contralateral kidneys. METHODS:Eighteen patients who underwent stent placement for unilateral renal artery stenosis presenting with hypertension and/or renal failure were studied before angiography an...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2002.00456.x
更新日期:2002-08-01 00:00:00
abstract::McAdoo et al. propose that patients with both circulating antiglomerular basement membrane antibody and antineutrophil cytoplasm antibody demonstrate a phenotype that lies between that of single-positive antiglomerular basement membrane disease and antineutrophil cytoplasm antibody-associated vasculitis. Specifically,...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1016/j.kint.2017.04.024
更新日期:2017-09-01 00:00:00
abstract::The monitoring of the levels of alloantibodies following transplantation might facilitate early diagnosis of chronic rejection (CR), the leading cause of renal allograft failure. Here, we used serial alloantibody surveillance to monitor patients with preoperative positive flow cytometric crossmatch (FCXM). Sixty-nine ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2010.556
更新日期:2011-05-01 00:00:00