| Theme | Blood Purification Solution | |
|---|---|---|
| Title | Osmotic agents in CAPD | |
| Publish Date | 1998/08 | |
| Author | Masahiko Nakamoto | Kidney Center, Saiseikai Yahata Hospital |
| Author | Chikao Yasunaga | Kidney Center, Saiseikai Yahata Hospital |
| Author | Gakusen Nishihara | Kidney Center, Saiseikai Yahata Hospital |
| Author | Tetsuhiko Yoshida | Kidney Center, Saiseikai Yahata Hospital |
| [ Summary ] | Ultrafiltration (waterremoval) in CAPD can obtained by the osmolar gap between plasma and dialysate. Therefore, the osmotic agent contained in the peritoneal dialysate becomes a major determinant in achieving successful CAPD. As one of several osmotic agents, glucose has been used for long time, since the beginning of CAPD, but it is also reported to have some unfavorable side effects like obesity, hyperlipidemia, hyperpermeability of peritoneal capillaries and impaired mesothelial regeneration. Clinical trials using glycerol, amino acid, glucose polymers and others have been done. However, independent use of glycerol or amino acid as an osmotic agent was found to be inadequate because of several adverse effects. Glucose polymers seem to need further observation in regard to their safety, though they can maintain effective ultrafiltration even after a long dwell time. Recently in Japan, albumin prepared from effluent has been tried again as an osmotic agent. |
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