Peritoneal clearance of homocysteine with icodextrin or standard glucose solution exchange

• Published in: Nephrology (Carlton, Vic.) Vic.), 2005-12, Vol.10 (6), p.571-575
• Main Authors: CZUPRYNIAK, ANETA, NOWICKI, MICHAL, CHWATKO, GRAZYNA, JANDER, ANNA, BALD, EDWARD
• Format: Article
• Language: English
• Subjects: Adult; Female; Glucans; Glucose; Hemodialysis Solutions - chemistry; high-performance liquid chromatography; homocysteine; Homocysteine - blood; Homocysteine - metabolism; Humans; icodextrin; Male; peritoneal dialysis; Peritoneal Dialysis, Continuous Ambulatory; Peritoneum - metabolism
• ISSN: 1320-5358; 1440-1797
• DOI: 10.1111/j.1440-1797.2005.00483.x

Background:  The aim of the study was to assess plasma homocysteine concentration in peritoneal dialysis patients, and to compare the effect of different peritoneal solutions (glucose‐based and icodextrin‐based) on peritoneal clearance of homocysteine. Methods:  The study group comprised 10 chronic peritoneal dialysis patients; the control group comprised 15 healthy, age‐matched non‐obese subjects with normal renal function. Patients with vitamin B12 or folate deficiency were excluded. In all subjects, plasma homocysteine and dialysis adequacy parameters were assessed at baseline. The clearance study was carried out with 2.27% glucose and 7.5% icodextrin solutions (12‐h dwell time). Results:  Mean dialysate concentration of homocysteine was similar for both glucose and icodextrin solutions (8.3 ± 3.2 and 8.4 ± 1.9 µmol/L, respectively), but homocysteine clearance was significantly higher for icodextrin than glucose solution (1.82 ± 0.57 vs 1.39 ± 0.53 mL/min per 1.73 m2P = 0.01). Net ultrafiltration after icodextrin solution was also higher than after glucose solution (599 ± 136 mL vs 134 ± 337 mL, P