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Bicarbonate/lactate-based peritoneal dialysis solution increases cancer antigen 125 and decreases hyaluronic acid levels

Jones, Suzanne, Holmes, Clifford J., Krediet, Raymond T., Mackenzie, Ruth, Faict, Dirk, Tranaeus, Anders, Williams, John David, Coles, Gerald A. and Topley, Nicholas 2001. Bicarbonate/lactate-based peritoneal dialysis solution increases cancer antigen 125 and decreases hyaluronic acid levels. Kidney International 59 (4) , pp. 1529-1538. 10.1046/j.1523-1755.2001.0590041529.x

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Abstract

Bicarbonate/lactate peritoneal dialysate increases cancer antigen 125 and decreases hyaluronic acid levels. Background In a randomized, controlled trial comparing a pH neutral, bicarbonate/lactate (B/L)-buffered PD solution to conventional acidic, lactate-buffered solution (C), the overnight dialysate levels of markers of inflammation/wound healing [hyaluronic acid (HA)], mesothelial cell mass/membrane integrity [cancer antigen 125 (CA125)], and fibrosis [transforming growth factor-1 (TGF-1) and procollagen I peptides (PICP)] were assessed over a six-month treatment period. Methods One hundred six patients were randomized (2:1) to either the B/L group or C group. Overnight effluents were collected at entry into the study (time = 0 all patients on control solution) and then at three and six months after randomization. Aliquots were filtered, stored frozen, and assayed for HA, CA125, TGF-1, and PICP. Differences between groups were assessed by repeated-measures analysis of variance for unbalanced data using the SAS procedure MIXED. Results In patients treated with B/L, there was a significant (P = 0.03) increase in CA125 after six months compared with time = 0 (19.76 11.8 vs. 24.4 13.8 U/mL; mean SD; N = 51). In the same group of patients, HA levels were significantly decreased at both three and six months in the B/L-treated group (time = 0, 336.0 195.2; time = 3 months, 250.6 167.6; and time = 6 months, 290.5 224.6 ng/mL; mean SD; P = 0.006, N = 47 and P = 0.003, N = 48, respectively). No significant changes in CA125 or HA levels were observed in the control group. There were no significant changes observed in the levels of PICP or TGF-1 in the B/L or C group over the six-month treatment period. Conclusions These results suggest that continuous therapy with the B/L solutions modulates the levels of putative markers of peritoneal membrane integrity and inflammation. In the long term, this may positively impact the peritoneal membrane, increasing its life as a dialyzing organ.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Systems Immunity Research Institute (SIURI)
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Publisher: NPG
ISSN: 0085-2538
Last Modified: 30 Jun 2017 03:01
URI: http://orca-mwe.cf.ac.uk/id/eprint/45503

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