Background A multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis （PD） solutions. Some researchers believe that 6 Lid is enough for adequate dialysis, but there...Background A multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis （PD） solutions. Some researchers believe that 6 Lid is enough for adequate dialysis, but there is no multi-center prospective study on Chinese population to confirm this. In this study, we evaluated the efficacy and safety of domestic PD solution （Changfu） and its difference between 6 L and 8 L dosage. Methods Adult PD patients who had taken PD therapy for at least one month were selected and divided into four groups according to two dialysis solution brands and two dialysis dosages, i.e., 6 L dose with Changfu dialysis solution, 6 L dose with Baxter dialysis solution, 8 L dose with Changfu dialysis solution, and 8 L dose with Baxter dialysis solution. After 48 weeks, the changes of primary and secondary efficacy indices were compared between different types and different dosages. We also analyzed the changes of safety indices. Results Changes of Kt/V from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of creatinine clearance rate （Ccr）. Normalized protein catabolic rate （nPCR） from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of net ultrafiltration volume （nUF） and estimated glomerular filtration rate （eGFR）. Changes of nPCR from baseline to 48 weeks between 6 L and 8 L showed no statistical differences; so did those of nUF and eGFR. The decline of Kt/V from baseline to 48 weeks in 6 L group was more than that in 8 L group. Change of Ccr was similar. During the 48-week period, the mean Kt/V was above 1.7/w, and mean Ccr was above 50 L.1.73 m-2.w1. More adverse events were found in Changfu group before Changfu Corporation commenced technology optimization, and the statistical differences disappeared after that. Conclusions The domestic PD solution （Changfu） was proven to be as effective as Baxter dialysis solution. During 48- week period, a dosage of 6 L/d was enough for these patients to reach adequate PD. Clinical study promotes technological optimization, further helps to improve the safety indices of the medical products.展开更多
The peritoneum response to peritoneal dialysis can lead to fibrosis. The transforming growth factor-β1 （TGF-β1） plays an important role in regulating tissue repair and remodeling after injury. Excessive synthesis ...The peritoneum response to peritoneal dialysis can lead to fibrosis. The transforming growth factor-β1 （TGF-β1） plays an important role in regulating tissue repair and remodeling after injury. Excessive synthesis and deposition of matrix proteins by peritoneal mesothelial cells can lead to structural and functional changes in the peritoneal membrane, jeopardizing the long-term efficacy of peritoneal dialysis （PD）. Prolonged exposure to high glucose concentrations in PD fluid has been implicated as a major stimulus to matrix accumulation, through the induction of transforming growth factor-β1 （TGF-β1）.展开更多
Aim. To elucidate whether an inhibited superoxide production(O 2 ) of neutrophils induced by commercial lactate based peritoneal dialysates(PDS) could be corrected after a transient intracel...Aim. To elucidate whether an inhibited superoxide production(O 2 ) of neutrophils induced by commercial lactate based peritoneal dialysates(PDS) could be corrected after a transient intracellular acidosis. Methods. The intracellular pH([pHi]) of human neutrophils incubatd in PDS was monitored with a spectrofluorometer with a pH sensitive dye (BCECF AM). Neutrophilic O 2 stimulated by zymosan was determined in PDS with the superoxide dismutase inhibitable ferricytochrome c reduction, using a spectrophotometer. Results. The severe intracellular acidosis induced within 5 min by PDS at an extracellular pH of 5.2 could be promptly and completely recovered by a neutralization of the pH of media. However, O 2 by neutrophils exposed to the PDS for as little as 5 min was drastically and persistently inhibited, even the acidic [pHi] of cells had been fully returned for 1h. Conclusions. The intracellular acidification of cells in the initial phase could be transient and reversible, but impaired cell functions, at least in part including O 2 generating system, might be consistent and irreversible in the early stage of the cellular acidosis in the peritoneal cavity of CAPD patients. The findings above may be of particular importance in both clinic and cell biology.展开更多
文摘Background A multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis （PD） solutions. Some researchers believe that 6 Lid is enough for adequate dialysis, but there is no multi-center prospective study on Chinese population to confirm this. In this study, we evaluated the efficacy and safety of domestic PD solution （Changfu） and its difference between 6 L and 8 L dosage. Methods Adult PD patients who had taken PD therapy for at least one month were selected and divided into four groups according to two dialysis solution brands and two dialysis dosages, i.e., 6 L dose with Changfu dialysis solution, 6 L dose with Baxter dialysis solution, 8 L dose with Changfu dialysis solution, and 8 L dose with Baxter dialysis solution. After 48 weeks, the changes of primary and secondary efficacy indices were compared between different types and different dosages. We also analyzed the changes of safety indices. Results Changes of Kt/V from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of creatinine clearance rate （Ccr）. Normalized protein catabolic rate （nPCR） from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of net ultrafiltration volume （nUF） and estimated glomerular filtration rate （eGFR）. Changes of nPCR from baseline to 48 weeks between 6 L and 8 L showed no statistical differences; so did those of nUF and eGFR. The decline of Kt/V from baseline to 48 weeks in 6 L group was more than that in 8 L group. Change of Ccr was similar. During the 48-week period, the mean Kt/V was above 1.7/w, and mean Ccr was above 50 L.1.73 m-2.w1. More adverse events were found in Changfu group before Changfu Corporation commenced technology optimization, and the statistical differences disappeared after that. Conclusions The domestic PD solution （Changfu） was proven to be as effective as Baxter dialysis solution. During 48- week period, a dosage of 6 L/d was enough for these patients to reach adequate PD. Clinical study promotes technological optimization, further helps to improve the safety indices of the medical products.
文摘The peritoneum response to peritoneal dialysis can lead to fibrosis. The transforming growth factor-β1 （TGF-β1） plays an important role in regulating tissue repair and remodeling after injury. Excessive synthesis and deposition of matrix proteins by peritoneal mesothelial cells can lead to structural and functional changes in the peritoneal membrane, jeopardizing the long-term efficacy of peritoneal dialysis （PD）. Prolonged exposure to high glucose concentrations in PD fluid has been implicated as a major stimulus to matrix accumulation, through the induction of transforming growth factor-β1 （TGF-β1）.
文摘Aim. To elucidate whether an inhibited superoxide production(O 2 ) of neutrophils induced by commercial lactate based peritoneal dialysates(PDS) could be corrected after a transient intracellular acidosis. Methods. The intracellular pH([pHi]) of human neutrophils incubatd in PDS was monitored with a spectrofluorometer with a pH sensitive dye (BCECF AM). Neutrophilic O 2 stimulated by zymosan was determined in PDS with the superoxide dismutase inhibitable ferricytochrome c reduction, using a spectrophotometer. Results. The severe intracellular acidosis induced within 5 min by PDS at an extracellular pH of 5.2 could be promptly and completely recovered by a neutralization of the pH of media. However, O 2 by neutrophils exposed to the PDS for as little as 5 min was drastically and persistently inhibited, even the acidic [pHi] of cells had been fully returned for 1h. Conclusions. The intracellular acidification of cells in the initial phase could be transient and reversible, but impaired cell functions, at least in part including O 2 generating system, might be consistent and irreversible in the early stage of the cellular acidosis in the peritoneal cavity of CAPD patients. The findings above may be of particular importance in both clinic and cell biology.
