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低葡萄糖降解产物腹膜透析液ppt课件
Basic fibroblast growth factor (bFGF) expression was evaluated by a bFGF immunostaining of the peritoneum Nephrol Dial Transplant(2010)25:1479-1488 Advanced glycation end-product (AGE) accumulation was evaluated by an AGE immunostaining of the peritoneum Nephrol Dial Transplant(2010)25:1479-1488 (19)Schalkwijk et al.,?Reduced 1,2-dicarbonyl compounds in bicarbonate/lactate-buffered peritoneal dialysis fluids based on glucose polymers or amino acids. Perit Dial Int 2000;20:796-798. Reduces GDP compared with conventional glucose solution 3-DG ?mol/L MGO ?mol/L GO ?mol/L Methylglyoxal (?mol/L) Glyoxal (?mol/L) 3-Deoxyglucosone (?mol/L) 多聚糖腹透液(Icodextrin) Reduced AGE FormationCML* Generation–Icodextrin vs Dextrose CML Generation (pmol/mL) Ueda, et al. Kidney Int. 2000;58:2518-2524. *N?-carboxymethyllysine; **P =.001 vs heat-sterilized 1.5% dextrose ** ** 1.36% glucose (filter-sterilized) 1.36% glucose (heat-sterilized) Icodextrin 多聚糖腹透液(Icodextrin) With the same risk factors, patients using Extraneal (usually older), have a 32% reduced risk of transfer to HD. Retrospective multicenter study 1045 patients Mean follow-up: 14,5 months Restores fluid balance Lower probability of transfer to HD with Extraneal Divino F.J.C. and the Spanish 67 hospital group. Peri Dial Intern 23 Suppl. 1 Feb. 2003:S19. EG (Extraneal patients) GG (Glucose only patients) 多聚糖腹透液(Icodextrin) Patients Reporting Better Health (%) Icodextrin patients report better health after 1 year* Wolfson, et al. Am J Kidney Dis. 2002;40:1055-1065 30 25 20 15 10 5 0 N=25 *Patients who completed both baseline and week 52 KDQoL forms. N=41 2.27% glucose Icodextrin p0.05 vs 2.27% glucose Improvements in Quality of Life with Extraneal Randomized, double- blind, active-controlled study N = 66 Study duration 52 weeks CAPD and APD 多聚糖腹透液(Icodextrin) Icodextrin 优缺点总结 David W JOHNSON,et al,. Recommendations for the use of icodextrin in peritoneal dialysis patients. NEPHROLOGY 2003; 8 , 1–7 多聚糖腹透液
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