#2361 The influence of glucose biocompatible solutions to the clinical outcomes of patients treated with continuous ambulatory peritoneal dialysis

Abstract

Abstract Background and Aims The use of biocompatible glucose solutions is associated with longer preservation of residual renal function and less frequent occurrence of complications in patients on peritoneal dialysis. The aim of this study was to examine the influence of conventional and biocompatible glucose solutions to laboratory parameters and clinical outcomes of PD patients during a four-year period at Zvezdara University Medical Center. Method This retrospective study included 25 incident patients treated with continuous ambulatory peritoneal dialysis (CAPD) during the follow up period from 2018 to 2022. During 2018/2019 these patients used conventional solutions (Dianeal PD4) containing lactate as a buffer, while due to the change in solution production technology in 2020/2021, all patients were transferred to a biocompatible solution (Physioneal 40) with lactate and bicarbonate as a buffer. Clinical outcomes were compared in relation to the administered solution: pain during infusion (measured by a Visual Analogue Scale—VAS), correction of anaemia and bicarbonate, average annual 24h diuresis and 24h ultrafiltration, occurrence of CAPD peritonitis. The statistical significance of the differences between the two periods was checked using the SPSS. Results The average age of 25 patients was 61 ± 14 years, of which 59.1% were male and 40.9% female. The average BMI was 28.5 ± 5.30 kg/m2, and the most common comorbidities were HTA and DM. No statistically significant difference was found for the values of Le, albumin, Hb, PTH, bicarbonate, and K (p ˃ 0.05). During the use of biocompatible solutions, patients had statistically significantly lower Na values (138.84 ± 2.63 vs 137.17 ± 2.41 mmol/l, p = 0.0116, 95% CI 137.15– 138.84) and lower CRP values (15.3 ± 3.3 mg/l vs 7.7 ± 3.2, p = 0.0003, 95% CI 18.60-4.50). Although the dialysis exposure was longer, the rate of peritonitis was lower during the use of biocompatible solutions, but without a statistically significant difference (0.40 episodes per patient-year, vs 0.31 episodes per patient-year, p ˃ 0.05). No statistical significance was found in 24h diuresis value (900 ml vs 750 ml, p = 0.167.95% CI 686.90–1203.31) but the value is expected to be lower due to dialysis duration. Conclusion Our study showed that patients treated with the CAPD method while using a biocompatible solution have statistically significantly higher values of 24h ultrafiltration, lower Na and CRP values and less occurrence of pain during infusion, which significantly affects the quality of life. Although this may indicate better preservation of the peritoneal membrane, a prospective and randomized study is needed to clarify these potential differences.