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The BALNET Study

The BALNET Study. The BALNET Study. Source

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The BALNET Study

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  1. The BALNET Study

  2. The BALNET Study Source Kim SG, Kim S, Hwang YH,et al. Could solutions low in glucose degradation products preserve residual renal function in incident peritoneal dialysis patients? A 1-year multicenter prospective randomized controlled trial (the Balnet Study). Perit Dial Int. 2008;28:S117–S122.

  3. Background Recurrent episodes of peritonitis, loss of residual renal function (RRF), and loss of peritoneal function lead most peritoneal dialysis (PD) patients switch to hemodialysis therapy. It has been suggested that glucose degradation products (GDPs) produced during heat sterilization and storage of PD solution modulate RRF in PD. In vitro studies of PD solutions demonstrated that a lactate-buffered fluid with neutral pH and low glucose degradation products (LF) has better biocompatibility than a conventional acidic lactate-buffered fluid (CF). This study was undertaken to compare LF with CF with patients starting peritoneal dialysis.

  4. Aim To compare the clinical outcomes of LF and CF and to test the hypothesis that use of low-GDP PD solution favorably affects preservation of RRF.

  5. Methods

  6. Key results • The residual glomerular filtration rate (GFR) in patients using LF tended to be higher than that of patients on CF (P=0.057 by repeated-measures analysis of variance) (Fig. 1A). • A significant difference in the changes of residual GFR between the two groups (p=0.009), a difference that was especially marked in the subgroup whose baseline residual GFR was more than 2 mL/min/1.73 m2 (Fig. 1B). • Serum total CO2 levels were higher (p=0.001) and serum anion gap was lower (p=0.019) in the LF group. • No differences between groups for Kt/V, C-reactive protein, or normalized protein equivalent of nitrogen appearance.

  7. Conclusion This study was designed to test whether the use of low-GDP fluid could help to preserve RRF better than the use of conventional fluid. Results showed that LF preserved RRF better, especially in patients whose baseline residual GFR was higher than 2 mL/min/1.73 m2. Additionally, pH-neutral PD fluid may improve acid–base balance as compared to CF. LF may preserve RRF and may improve acid–base balance in incident PD patients.

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