Effects of icodextrin on glycemic and lipid profiles in diabetic patients undergoing peritoneal dialysis

被引:48
作者
Babazono, Tetsuya
Nakamoto, Hidetomo
Kasai, Kenji
Kuriyama, Satoru
Sugimoto, Tokuichiro
Nakayama, Masaaki
Hamada, Chieko
Furuya, Ryuichi
Hasegawa, Hirofumi
Kasahara, Masato
Moriishi, Misaki
Tomo, Tadashi
Miyazaki, Masanobu
Sato, Manaka
Yorioka, Noriaki
Kawaguchi, Yoshindo
机构
[1] Tokyo Womens Med Univ, Sch Med, Ctr Diabet, Div Nephrol & Hypertens, Tokyo 1628666, Japan
[2] Saitama Med Sch, Dept Nephrol, Saitama, Japan
[3] Fuji City Gen Hosp, Div Nephrol, Fuji, Shizuoka, Japan
[4] Saiseikai Cent Hosp, Div Nephrol, Tokyo, Japan
[5] Mitsui Mem Hosp, Dept Internal Med, Div Nephrol, Tokyo 101, Japan
[6] Tohoku Univ, Grad Sch Med, Res Div Dialysis & Chron Kidney Dis, Sendai, Miyagi 980, Japan
[7] Juntendo Univ, Sch Med, Dept Internal Med, Div Nephrol, Tokyo 113, Japan
[8] Iwata City Hosp, Dept Internal Med, Div Renal, Iwata, Japan
[9] Kinki Univ, Sch Med, Sakai Hosp, Dept Med,Div Nephrol & Dialysis, Osaka 589, Japan
[10] Kyoto Univ, Grad Sch Med, Dept Med & Clin Sci, Kidney Grp, Kyoto, Japan
[11] Tsuchiya Gen Hosp, Akane Fdn, Dept Artificial Organs, Hiroshima, Japan
[12] Oita Univ, Fac Med, Dept Infect Dis, Div Pathogenesis & Dis Control, Oita 87011, Japan
[13] Nagasaki Univ Hosp, Dept Internal Med 2, Nagasaki, Japan
[14] Baxter Ltd, Tokyo, Japan
[15] Hiroshima Univ, Grad Sch Biomed Sci, Dept Adv Nephrol, Hiroshima, Japan
[16] Kanagawa Prefectural Hosp, Nurses Training Sch, Div Nephrol, Yokohama, Kanagawa, Japan
关键词
icodextrin; continuous ambulatory peritoneal dialysis ~; automated peritoneal dialysis; diabetic nephropathy; Hemoglobin A1C; cholesterol; triglyceride;
D O I
10.1159/000105123
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Aim: Icodextrin reduces glucose absorption from the peritoneal dialysate. We conducted this prospective, open-labeled, multicenter study to determine the effects of icodextrin on glycemic and lipid parameters in diabetic patients undergoing continuous ambulatory peritoneal dialysis ( PD) or automated PD. Methods: Patients were recruited from 15 institutions in Japan, and a total of 51 patients ( 15 women and 36 men, mean age: 59 8 10 years, median duration of PD: 13 months) were enrolled. The patients were administered an overnight or daytime dwell of 1.5 or 2.01 of 7.5% icodextrin-containing solution. At baseline and 3, 6, 9 and 12 months after the start of icodextrin, nonfasting blood was drawn for measurement of glycated hemoglobin (HbA1C) and serum lipids. Results: During icodextrin treatment, there was no change in overall HbA1C levels compared to baseline values; however, for those with baseline HbA1C >= 6.5% ( n = 22), significant decreases in HbA1C were observed. Mean total/LDL cholesterol and triglycerides were decreased significantly during icodextrin treatment, with greater decreases for patients with baseline total cholesterol >= 220 mg/dl, LDL cholesterol >= 120 mg/dl or triglycerides >= 150 mg/dl. HDL cholesterol did not differ at any time point; however, values for patients with baseline HDL cholesterol < 40 mg/dl tended to increase with marginal significance. Conclusions: In the current study, switching from glucose-containing dialysis solution to icodextrin resulted in improved lipid profiles and possibly a favorable metabolic profile, particularly in patients with poor glycemic control. These hypotheses remain to be proven in controlled clinical trials. Copyright (c) 2007 S. Karger AG, Basel.
引用
收藏
页码:409 / 415
页数:7
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