Kidney Week

Abstract: FR-PO1100

Efficacy and Safety of Biocompatible 4.25% Dextrose Peritoneal Dialysis Solution in Japan

Session Information

• Home Dialysis: Modalities, Barriers, Utilization, and Clinical Outcomes
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

• Mori, Takefumi, Division of Nephrology and Hypertension, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Japan

Takefumi Mori, MD, PhD

• Yabana, Ikuko, Division of Nephrology and Hypertension, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Japan

Ikuko Yabana, MD, PhD

• Kikuchi, Yukari, Division of Integrative Renal Replacement Therapy, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Japan

Yukari Kikuchi

• Yuki, Tsubasa, Division of Nephrology and Hypertension, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Japan

Tsubasa Yuki, MD

• Kanomata, Yoshitaka, Division of Nephrology and Hypertension, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Japan

Yoshitaka Kanomata, MD

• Sato, Emiko, Division of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan

Emiko Sato, PhD

• Ito, Hiroki, Division of Nephrology and Hypertension, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Japan

Hiroki Ito, MD

• Hirose, Takuo, Division of Physiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Japan

Takuo Hirose, PhD

Background

Since after the increased encapsulating peritoneal sclerosis, high dextrose concentration peritoneal dialysis (PD) solution is not commonly used in Japan. The ultrafiltration is limited by 1.5%-2.5% dextrose PD solution even together with icodextrin, thereby results in combination or conversion of hemodialysis. Bicarbonate contained neutral biocompatible solution is now available to use in Japan. We therefore analyzed the efficacy and safety of the biocompatible 4.25% dextrose PD solution.

Methods

Efficacy and safety were determined by 4.25% dextrose PD solution is applied according to the modified peritoneal equilibration test (modified PET). Safety of the biocompatible PD solution was also determined by the measurement of glucose degradation products (GDPs) by Liquid Chromatograph Mass Spectrometer and compared to those of acidic PD solution. We have performed modified PET by 1500mL of 4.25% dextrose PD solution because total drain volume with 2000mL dwell could not tolerate in relatively smaller body of Japanese population.

Results

Total fluid removal ≥300mL with 4 hour dwell with 1500mL of biocompatible 4.25% dextrose PD solution was observed in 60 patients (80.0%), while 15 patients had <300mL (20.0%). Sodium dip of 5 mmol/L at 1 hour dwell was observed in 58 patients (77.3%), while <5 mmol/L was observed in 17 patients (22.7%). Possitive correlation were observed between sodium dip and total fluid removal. Methylglyoxal level of biocompatible 4.25% dextrose PD solution was lower than that of acidic PD solution, similar to that of biocompatible 1.5% or 2.5% PD solution and icodextrin.

Conclusion

Biocompatible 4.25% dextrose PD solution had sodium dip and positive total fluid removal as it is in ISPD guideline. GDPs of biocompatible 4.25% dextrose PD solution is significantly lower than that of acidic PD solution which is even lower than that of patients' plasma level. We conclude that biocompatible 4.25% dextrose PD solution is effective and safe solution which could have beneficial to the Japanese PD patients.

Funding

• Commercial Support – JMS, Southern TOHOKU Research Institute for Neuroscience