GLUCOREGULATORY HORMONES AND CHOICE OF OSMOTIC AGENT IN PERITONEAL DIALYSIS

• Published in: Peritoneal dialysis international Vol. 30; no. 6; pp. 626 - 632
• Main Authors: MUJAIS, Salim, TAPIAWALA, Shruti N, YIP, Paul, AL-ROWAIE, Fadel, BURDZY, Dorothy, BARGMAN, Joanne M, OREOPOULOS, Dimitrios G
• Format: Journal Article
• Language: English
• Published: Milton, ON Multimed Inc 01.11.2010; Multimed
• Subjects: Adult; Aged; Amino Acids - therapeutic use; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Glucose - analysis; C-Peptide - blood; Creatinine - analysis; Dialysis Solutions - therapeutic use; Dopamine - blood; Emergency and intensive care: renal failure. Dialysis management; Epinephrine - blood; Female; Glucagon - blood; Glucose - analysis; Glucose - therapeutic use; Human Growth Hormone - blood; Humans; Insulin - blood; Insulin-Like Growth Factor I - analysis; Intensive care medicine; Male; Medical sciences; Middle Aged; Norepinephrine - blood; Peptide Hormones - analysis; Peritoneal Dialysis; Prospective Studies; Sodium - analysis; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Urea - analysis; Young Adult; Kidney disease; Extrarenal dialysis; nutrition; Urinary system disease; Glucose sparing; amino acid solutions; Renal failure; Glucose; Peritoneal dialysis; glucoregulatory hormones
• ISSN: 0896-8608; 1718-4304
• DOI: 10.3747/pdi.2009.00107

The present study was performed to explore the range of effects of amino acid-based peritoneal dialysis (PD) solutions on glucoregulatory hormones in comparison with an osmotically equivalent glucose-based solution. ♢ 13 adult nondiabetic patients on PD underwent 2 peritoneal dwells of 2 hours' duration with either 1.5% dextrose solution or 1.1% amino acid solution. Serial sampling for glucoregulatory hormones was done throughout the duration of the dwell. ♢ Instillation of the 1.5% dextrose solution resulted in a modest change in plasma glucose, paralleled by a small increase in plasma insulin levels and plasma insulin-like growth factor (IGF-1). Plasma glucagon was not changed and plasma growth hormone level declined. Instillation of the 1.1% amino acid solution resulted in an increase in plasma glucose, plasma insulin, plasma glucagon, and plasma IGF-1. Plasma growth hormone level declined. Both solutions led to an increase in plasma norepinephrine but no changes were observed in epinephrine or dopamine. ♢ Our observations suggest that the mere replacement of glucose by amino acids in PD solutions does not necessarily imply "glucose sparing" from the perspective of induction of a glucoregulatory hormonal response because of the aminogenic stimulation of secretion of multiple hormones.