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Kidney Week

Abstract: TH-OR093

Effects of Long-Term Treatment with Low GDP, pH Neutral Solution on the Peritoneal Functions and Morphological Changes in PD Patients

Session Information

  • Peritoneal Dialysis
    November 02, 2017 | Location: Room 290, Morial Convention Center
    Abstract Time: 05:30 PM - 05:42 PM

Category: Dialysis

  • 608 Peritoneal Dialysis

Authors

  • Tawada, Mitsuhiro, Koujyukai Kasugai Hospital, Kasugai, Japan
  • Ito, Yasuhiko, Aichi Medical University, Nagakute, Japan
  • Hamada, Chieko, Juntendo University, Tokyo, Japan
  • Mizuno, Masashi, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Suzuki, Yasuhiro, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Sakata, Fumiko, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Maruyama, Shoichi, Nagoya University Graduate School of Medicine, Nagoya, Japan
Background

Effects of long-term treatment with acidic solution on the peritoneal membrane are well known. However, the peritoneal membrane damage induced by long-term peritoneal dialysis low GDP, pH neutral solution (neutral solution) has not been reported in detail. The aim of this study was to investigate the effects of neutral solutions on peritoneal functions and morphological changes.

Methods

This study used pathological and immunopathological techniques to assess peritoneal membrane biopsy samples from peritoneal dialysis patients treated with acidic solution or neutral solution. And we investigate the D/P Cr changes by long-term neutral solution treatments.

Results

The morphological changes were compared between the acidic solution group (n=54) and neutral solution group (n=67). According to the analyses, the ratio of lumen diameter to vessel diameter (L/V ratio) was significantly smaller (p<0.01), peritoneal membrane was thicker (p<0.01) and accumulation of advanced glycation end-products (AGEs) was higher in the acidic solution group than in the neutral solution group (p<0.01). In addition, acidic solution group (n=33) and neutral solution group (n=31) who were treated for 4 to 10 years were compared. In this study, the L/V ratio was significantly smaller (p<0.01) and peritoneal membrane was thicker (p=0.034), and there were no significant differences in number of CD31 positive vessels and CD68 positive cells between the two groups. Furthermore, the L/V ratio in the acidic solution group significantly decreased over time (p<0.01), no such change was seen in the neutral solution group. According to the results of peritoneal equilibration tests for long term neutral solution treatments, D/P Cr also did not change over time.

Conclusion

These findings suggest that neutral peritoneal dialysis solutions prevent morphological changes and keep peritoneal functions with no changes in D/P Cr after long term PD treatment.