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Abstract: TH-PO291

Safety and Efficacy of a Zero Sodium Peritoneal Solution

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Turner, Jeffrey M., Yale University, Hamden, Connecticut, United States
  • Finkelstein, Fredric O., Yale University, Hamden, Connecticut, United States
  • Rao, Veena, Yale University, Hamden, Connecticut, United States
  • Griffin, Matthew, Yale School of Medicine, Hamden, Connecticut, United States
  • Mahoney, Devin, Yale University, Hamden, Connecticut, United States
  • Testani, Jeffrey M., Yale University, Hamden, Connecticut, United States
Background

Sodium (Na) removal with conventional peritoneal dialysis solutions, which have a Na concentration similar to serum, primarily occurs by means of convective clearance. Zero Na peritoneal solution with a high osmolarity may offer more effective Na removal given the large Na concentration gradient to serum. This solution could have clinical application as an intermittent therapy for venous congestion.

Methods

This was a randomized open label crossover study in 10 established peritoneal dialysis patients comparing zero Na dialysis solution (10% dextrose, ~505mOsm/L) to standard 4.25% dextrose solution (485mOsm/L). Patients underwent a 1liter dwell for 120 minutes with both solutions at two separate study visits. Serum and dialysate sodium were monitored every 15 minutes, and intraperitoneal volume was determined using indicator dilution technique with I-131 albumin. (NCT03801226; IND141103)

Results

Total Na removal and ultrafiltration were significantly greater with the zero Na solution, and Na removal rate was highest in the first 30 minutes (figure 1). There was a small decrease in serum Na of 1meq/L after 120 minutes with the zero Na solution. There were no significant differences between the two solutions in non-Na plasma electrolytes at 120 minutes. While serum glucose increased with both solutions, this increase was not significantly different between the two solutions at 120 minutes. There were no significant differences in blood pressure trends.

Conclusion

Despite similar osmolarities, zero Na peritoneal solution results in more effective Na clearance and higher UF volume. The solution was well tolerated without significant adverse changes in blood pressure or off target electrolytes.

Funding

  • Commercial Support