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Relationship Between Effluent Levels of β 2 ‐Microglobulin and Peritoneal Injury Markers in 7.5% Icodextrin‐Based Peritoneal Dialysis Solution
Author(s) -
Minami Satoshi,
Hora Kazuhiko,
Kamijo Yuji,
Higuchi Makoto
Publication year - 2007
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1744-9987.2007.00493.x
Subject(s) - medicine , peritoneal dialysis , effluent , icodextrin , continuous ambulatory peritoneal dialysis , beta 2 microglobulin , environmental engineering , engineering
The removal of low molecular weight proteins such as β 2 ‐microglobulin (β 2 MG) is accelerated by using a 7.5% icodextrin‐based peritoneal dialysis solution (ICO) dwell. To examine the possibility of peritoneal injury in ICO, we investigated the relationship between β 2 MG and the injury markers in effluent. Sixteen ICO‐treated patients (11 male and five female, mean age 50.1 ± 10.9 years) with continuous ambulatory peritoneal dialysis (CAPD; mean duration 54.6 ± 30.8 months) were studied. The patients were treated with ICO 2 L and 2.27% glucose‐based solution 2 L for an 8‐h dwell and the effluent was collected. We investigated the correlations between β 2 MG and the injury markers (e.g. hyaluronic acid [HA], interleukin‐6 [IL‐6], matrix metalloproteinase‐2 [MMP‐2]) in each effluent sample. The β 2 MG level in the ICO effluent was 8978 ± 2431 μg/L, significantly higher than in the 2.27% glucose‐based solution effluent (6454 ± 2956 μg/L; P = 0.0032). The levels of HA and MMP‐2 in ICO effluent were significantly higher than those in the 2.27% glucose‐based solution effluent ( P = 0.00214, P = 0.0113, respectively). There was a trend toward higher IL‐6‐values in ICO effluent, although no significant differences were seen. There were positive correlations between levels of various injury markers and β 2 MG. We propose that the subclinical injury of the peritoneum by ICO treatment may accelerate peritoneal permeability to increase β 2 MG in effluent. ICO's biocompatibility might not be superior to that of glucose‐based solution.