scholarly journals Peritoneal Protein Losses and Cytokine Generation in Automated Peritoneal Dialysis with Combined Amino Acids and Glucose Solutions

2007 ◽  
Vol 2007 ◽  
pp. 1-5 ◽  
Author(s):  
H. L. Tjiong ◽  
F. J. Zijlstra ◽  
T. Rietveld ◽  
J. L. Wattimena ◽  
J. G. M. Huijmans ◽  
...  
Keyword(s):  
Amino Acids ◽  
Peritoneal Dialysis ◽  
Protein Energy Malnutrition ◽  
Automated Peritoneal Dialysis ◽  
Necrosis Factor Alpha ◽  
Protein Energy ◽  
Factor Alpha ◽  
Dialysis Solutions ◽  
Control Protein ◽  
Necrosis Factor

Objectives. Protein-energy malnutrition as a consequence of deficient protein intake frequently occurs in peritoneal dialysis (PD) patients. Previously, we showed that peritoneal dialysate containing a mixture of amino acids (AA) and glucose has anabolic effects. However AA-dialysate has been reported to increase intraperitoneal protein and AA losses and the release of proinflammatory cytokines (interleukine-6 (IL-6) and tumor necrosis factor alpha (TNFα)). We investigated the effect of AA plus glucose (AAG) solutions on peritoneal protein losses and cytokine generation.Methods. In 6 patients on standard automated peritoneal dialysis (APD) 12 APD sessions of 6 cycles each were performed during the night using dialysate containing 1.1% AA plus glucose or glucose alone as control. Protein losses and TNFαand IL-6 concentrations were measured in dialysates separately collected from nightly cycling and daytime dwell.Results. The 24 hour-protein losses with AAG (median 6.7 g, range 4.7–9.4 g) were similar to control dialysate (median 6.0 g, range 4.2–9.2 g). Daytime dialysate IL-6 levels were higher after nightly AAG dialysis than after control dialysis (142 pg/ml and 82 pg/ml, respectively,P<.05). TNFαconcentrations were very low.Conclusion. Nightly APD with amino acids containing dialysate was associated with an increase in peritoneal IL-6 generation during the day. The addition of AA to standard glucose dialysis solutions did not induce a significant increase of peritoneal protein losses.

Metabolic Effects of Incremental Doses of Intraperitoneal Amino Acids on Automated Peritoneal Dialysis

2010 ◽  
Vol 30 (2) ◽  
pp. 201-207 ◽  
Author(s):  
Brendan B. McCormick ◽  
Salim Mujais ◽  
Francine Poirier ◽  
Nicole Page ◽  
Susan Lavoie
Keyword(s):  
Peritoneal Dialysis ◽  
Protein Energy Malnutrition ◽  
Nutritional Supplement ◽  
Metabolic Effects ◽  
Serum Bicarbonate ◽  
Automated Peritoneal Dialysis ◽  
Ph Change ◽  
Protein Energy ◽  
Catabolic Rate ◽  
Higher Doses

BackgroundThe use of amino acid (AA) dialysate to ameliorate protein-energy malnutrition has been limited by adverse metabolic effects.ObjectiveWe undertook this study to examine the acute metabolic effects of escalating doses of AAs delivered with lactate/bicarbonate dialysate on automated peritoneal dialysis (APD).Patients and Methods12 APD patients were treated with conventional lactate-buffered dialysate (week 1), followed by lactate/bicarbonate-buffered dialysate (week 2), then 2 – 2.5 L 1.1% AA solution were added (week 3), and then an additional 2 – 2.5 L 1.1% AA were added (week 4). The primary outcomes were change in serum bicarbonate and pH, change in protein catabolic rate (PCR), and change in normalized ultrafiltration (milliliters/gram of carbohydrate infused).ResultsSerum bicarbonate rose from week 1 to week 2 (28.9 ± 3.2 vs 26.9 ± 4.1 mmol/L, p = 0.03). Addition of one bag of AAs led to a decline in plasma bicarbonate (26.9 ± 2.1 vs 28.9 ± 3.2 mmol/L, p < 0.01), which was further magnified by the addition of the second bag of AAs (23.8 ± 2.7 vs 26.9 ± 2.1 mmol/L, p < 0.01). Serum bicarbonate fell significantly by week 4 compared to week 1 (23.8 ± 2.7 vs 26.9 ± 3.2 mmol/L, p < 0.01) although there was no significant change in venous pH or PCR when week 4 was compared to week 1. Normalized ultrafiltration was stable for the first 3 weeks but rose significantly in week 4 compared to week 1 (5.32 ± 2.30 vs 4.14 ± 1.58 mL/g, p = 0.03).ConclusionsHigher doses of AAs mixed with newer bicarbonate/lactate dialysate on APD result in a small decrease in serum bicarbonate but improved normalized ultrafiltration. This merits further study as both a nutritional supplement and a glucose-sparing strategy.

scholarly journals Bicarbonate/lactate- and bicarbonate-buffered peritoneal dialysis fluids improve ex vivo peritoneal macrophage TNFalpha secretion.

1998 ◽  
Vol 9 (8) ◽  
pp. 1499-1506
Author(s):  
R K MacKenzie ◽  
C J Holmes ◽  
A Moseley ◽  
J P Jenkins ◽  
J D Williams ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Macrophage ◽  
Ex Vivo ◽  
Necrosis Factor Alpha ◽  
Direct Immunoassay ◽  
Significant Difference ◽  
Contrast Exposure ◽  
Factor Alpha ◽  
Necrosis Factor

Peritoneal macrophage (PMO) function was examined ex vivo after their in vivo exposure to either acidic, lactate-buffered solutions (PD4; 40 mM lactate, pH 5.2), bicarbonate/lactate-buffered solution (TBL; 25 mM/15 mM bicarbonate/lactate, pH 7.3), or bicarbonate-buffered solution (TB; 38 mM bicarbonate, pH 7.3), containing either 1.36 or 3.86% glucose. Initial experiments demonstrated that tumor necrosis factor-alpha (TNFalpha) release (assessed by TNF-direct immunoassay [DIA]) from PMO isolated from the peritoneal cavities of patients exposed to conventional fluid (PD4 1.36% glucose) was lowest after 30 min of intraperitoneal dwell (3591+/-1200 versus 28,946+/-9359 for 240-min dwell [pg/ml], n=5, P < 0.05). Five patients were exposed on 3 successive days to PD4, TBL, and TB for 30-min acute dwells containing 1.36% glucose in the first week and 3.86% glucose during the second. PMO TNFalpha release was assessed after ex vitro exposure to lipopolysaccharide (LPS). Exposure of PMO to TBL or TB (1.36% glucose) resulted in a significant increase in the generation of TNFalpha (pg/2 X 10(6) PMO) compared with PD4. TBL: 68,659+/-35,633, TB: 53,682+/-26,536 versus PD4 17,107+/-8996 (LPS 1.0 ng/ml, n=5 patients, P=0.043 versus PD4 for both). PMO that were recovered from PD4 and TB dwells (3.86% glucose) showed no significant difference in TNFalpha secretion (21,661+/-6934 and 23,923+/-9147, respectively). In contrast, exposure to TBL resulted in a significant increase (41,846+/-11,471) compared with PD4 (LPS 1.0 ng/ml, n=5 patients, P=0.043). These data demonstrate enhanced PMO function after in vivo exposure to bicarbonate- and bicarbonate/lactate-buffered solutions. This response was sustained in TBL alone at the highest glucose concentrations. These results suggest that the newer solutions, and particularly bicarbonate/lactate, might improve host defense status in peritoneal dialysis patients.

scholarly journals Lack of plasma interleukin-1 beta or tumor necrosis factor-alpha elevation during unfavorable hemodialysis conditions.

1991 ◽  
Vol 2 (5) ◽  
pp. 1007-1013
Author(s):  
A C Powell ◽  
L E Bland ◽  
C W Oettinger ◽  
S K McAllister ◽  
J C Oliver ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Chronic Renal Failure ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Interleukin 1 ◽  
Cellulose Triacetate ◽  
Tnf Alpha ◽  
Necrosis Factor Alpha ◽  
Factor Alpha ◽  
Necrosis Factor

Plasma interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) were determined by ELISA in 17 healthy controls, 23 HD patients, 10 continuous ambulatory peritoneal dialysis patients, and 15 chronic renal failure patients, as well as in 2 HD patients experiencing pyrogenic reactions. Another group of 10 chronic HD patients were dialyzed for 2.5 h, 5 with first-use Cuprophan membranes and 5 with first-use high-flux cellulose triacetate membranes. The mean bacterial and endotoxin concentrations of the dialysate used for HD treatments during the study period were 18,440 +/- 530 CFU/mL (mean +/- SEM) and 976 +/- 205 pg/mL, respectively. Blood specimens were obtained intradialysis and postdialysis for cytokine assay and were incubated to augment cytokine production. There was no difference in plasma IL-1 beta or TNF-alpha concentrations among the healthy controls, continuous ambulatory peritoneal dialysis patients, chronic renal failure patients, or HD patients. Neither cytokine increased significantly during or after HD. Two patients experiencing pyrogenic reactions had plasma TNF-alpha concentrations of 537 and 413 pg/mL, compared with matched controls of 6 and 0 pg/mL. Il-1 beta concentration did not differ from controls. We conclude that: (1) plasma IL-1 beta and TNF-alpha are not chronically elevated in chronic renal failure, continuous ambulatory peritoneal dialysis, or HD patients; (2) HD with new Cuprophan or cellulose triacetate membranes and high concentrations of dialysate endotoxin and bacteria does not cause elevation of circulating IL-1 beta or TNF-alpha; and (3) pyrogenic reactions might be mediated by TNF-alpha.

scholarly journals A monoclonal antibody to tumor necrosis factor alpha modify metabolic activity in lymphocytes from rat’s exposed chronic ethanol consumption

2013 ◽  
Vol 59 (4) ◽  
pp. 425-433
Author(s):  
M.V. Haretskaya ◽  
V.M. Sheibak
Keyword(s):  
Amino Acids ◽  
Monoclonal Antibody ◽  
Tumor Necrosis Factor ◽  
Free Amino ◽  
Tumor Necrosis ◽  
Wistar Rats ◽  
Necrosis Factor Alpha ◽  
Chronic Ethanol Consumption ◽  
Factor Alpha ◽  
Necrosis Factor

Administration of infliximab (a monoclonal antibody to tumor necrosis factor-a 1-10 mg/kg for 10 days) to Wistar rats consuming ethanol for 10 weeks significantly changed levels of free amino acids and their nitrogenous metabolites in liver lymphocytes.

Sign in / Sign up

Export Citation Format

Share Document