Abstract
To evaluate the biocompatibility of a peritoneal dialysis fluid with neutral pH and low levels of glucose degradation products (GDP), Stay-safe® Balance (NPDF) was compared with a conventional acidic PD fluid (APDF). In this study, 128 patients from 49 centers were divided into two groups : 40 patients were started on PD with NPDF (group I) and 88 patients were switched from APDF to NPDF (group II). The 49 non-diabetic patients in group II were divided into two subgroups according to the PD duration : less than 3 years : 28 patients ; more than 3 years : 21 patients. Effluent procollagen I peptide and hyaluronic acid levels were measured as markers of fibrosis, effluent and plasma 3-deoxyglucosone (3-DG) level as markers of the GDP level, effluent cancer antigen 125 (CA125) level and mesothelial cell area as markers of mesothelial cells, and effluent and plasma free- and total-pentosidine levels as markers of advanced glycation end products 0, 3, 9, 15, 21 and 27 months after the use starting to NPDF. There were no differences in the markers of fibrosis between groups I and II. CA125 increased in group II, while they remained unchanged in groupI. The mesothelial cell area decreased in group II, but not in group I. Effluent and plasma 3-DG were decreased in group II, but remained unchanged in group I. Effluent free- and total-pentosidine were unchanged in groups I and II. Plasma free- and total-pentosidine were decreased in group II, but remained unchanged in group I. Analysis of subgroups demonstrated a positive correlation between the plasma free- and total-pentosidine and PD duration. Decrease in plasma total-pentosidine was noted at 15 months in the group with a PD duration of more than 3 years. In conclusion, NPDF improves the mesothelial cell markers and decreases the circulating pentosidine levels. At least 15 months seem to be required for the washout of accumulated pentosidine, therefore, APDF should be switched to NPDF as early as possible.
