Peritoneal Protein Losses and Cytokine Generation in Automated Peritoneal Dialysis with Combined Amino Acids and Glucose Solutions

• Published in: Mediators of Inflammation Vol. 2007; no. 2; pp. 436 - 440
• Main Authors: TJIONG, H. L, ZIJLSTRA, F. J, RIETVELD, T, WATTIMENA, J. L, HUIJMANS, J. G. M, SWART, G. R, FIEREN, M. W. J. A
• Format: Journal Article
• Language: English
• Published: Sylvania, OH Hindawi Limiteds 01.01.2007; Hindawi; John Wiley & Sons, Inc; Hindawi Publishing Corporation
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Automation; Biological and medical sciences; C-Reactive Protein - metabolism; Complications and side effects; Continuous ambulatory peritoneal dialysis; Cross-Over Studies; Cytokines - biosynthesis; Cytokines - metabolism; Dialysis Solutions - metabolism; Emergency and intensive care: renal failure. Dialysis management; Female; General aspects; Glucose - metabolism; Humans; Intensive care medicine; Interleukin-6 - biosynthesis; Kidney Diseases - therapy; Male; Medical sciences; Middle Aged; Peritoneal dialysis; Peritoneal Dialysis - methods; Protein deficiency; Tumor Necrosis Factor-alpha - biosynthesis; Netherlands; Extrarenal dialysis; Aminoacid; Cytokine; Glucose; Peritoneal dialysis; Protein; Peritoneum
• ISSN: 0962-9351; 1466-1861
• DOI: 10.1155/2007/97272

Protein-energy malnutrition as a consequence of deficient protein intake frequently occurs in peritoneal dialysis (PD) patients. Previously, we showed that peritoneal dialysate containing a mixture of amino acids (AA) and glucose has anabolic effects. However AA-dialysate has been reported to increase intraperitoneal protein and AA losses and the release of proinflammatory cytokines (interleukine-6 (IL-6) and tumor necrosis factor alpha (TNFalpha)). We investigated the effect of AA plus glucose (AAG) solutions on peritoneal protein losses and cytokine generation. In 6 patients on standard automated peritoneal dialysis (APD) 12 APD sessions of 6 cycles each were performed during the night using dialysate containing 1.1% AA plus glucose or glucose alone as control. Protein losses and TNFalpha and IL-6 concentrations were measured in dialysates separately collected from nightly cycling and daytime dwell. The 24 hour-protein losses with AAG (median 6.7 g, range 4.7-9.4 g) were similar to control dialysate (median 6.0 g, range 4.2-9.2 g). Daytime dialysate IL-6 levels were higher after nightly AAG dialysis than after control dialysis (142 pg/ml and 82 pg/ml, respectively, P<.05). TNFalpha concentrations were very low. Nightly APD with amino acids containing dialysate was associated with an increase in peritoneal IL-6 generation during the day. The addition of AA to standard glucose dialysis solutions did not induce a significant increase of peritoneal protein losses.