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A randomized controlled trial of alanyl-glutamine supplementation in peritoneal dialysis fluid to assess impact on biomarkers of peritoneal health.
Vychytil, Andreas; Herzog, Rebecca; Probst, Paul; Ribitsch, Werner; Lhotta, Karl; Machold-Fabrizii, Veronika; Wiesholzer, Martin; Kaufmann, Michaela; Salmhofer, Hermann; Windpessl, Martin; Rosenkranz, Alexander R; Oberbauer, Rainer; König, Franz; Kratochwill, Klaus; Aufricht, Christoph.
Afiliación
  • Vychytil A; Department of Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria. Electronic address: andreas.vychytil@meduniwien.ac.at.
  • Herzog R; Department of Pediatrics and Adolescent Medicine, Division of Pediatric Nephrology and Gastroenterology, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Molecular Stress Research in Peritoneal Dialysis, Medical University of Vienna, Vienna, Austria.
  • Probst P; Department of Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria.
  • Ribitsch W; Department of Internal Medicine, Clinical Division of Nephrology, Medical University of Graz, Graz, Austria.
  • Lhotta K; Department of Internal Medicine 3 (Nephrology and Dialysis), Feldkirch Academic Teaching Hospital, Feldkirch, Austria.
  • Machold-Fabrizii V; Department of Medicine VI, Division of Nephrology and Dialysis, Wilhelminenspital, Vienna, Austria.
  • Wiesholzer M; Department of Internal Medicine I, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria.
  • Kaufmann M; Department of Medicine III, Nephrology, Transplantation, Rheumatology, Geriatrics, Ordensklinikum Linz, Krankenhaus der Elisabethinen Linz, Linz, Austria.
  • Salmhofer H; Department of Medicine I, Paracelsus Medical University, Salzburg, Austria.
  • Windpessl M; Department of Internal Medicine IV, Klinikum Wels-Grieskirchen, Wels, Austria.
  • Rosenkranz AR; Department of Internal Medicine, Clinical Division of Nephrology, Medical University of Graz, Graz, Austria.
  • Oberbauer R; Department of Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria.
  • König F; Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
  • Kratochwill K; Department of Pediatrics and Adolescent Medicine, Division of Pediatric Nephrology and Gastroenterology, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Molecular Stress Research in Peritoneal Dialysis, Medical University of Vienna, Vienna, Austria.
  • Aufricht C; Department of Pediatrics and Adolescent Medicine, Division of Pediatric Nephrology and Gastroenterology, Medical University of Vienna, Vienna, Austria.
Kidney Int ; 94(6): 1227-1237, 2018 12.
Article en En | MEDLINE | ID: mdl-30360960
In early clinical testing, acute addition of alanyl-glutamine (AlaGln) to glucose-based peritoneal dialysis (PD) fluids restored peritoneal cellular stress responses and leukocyte function. This study was designed to test the effect of extended treatment with AlaGln-supplemented PD fluid on biomarkers of peritoneal health. In a double-blinded, randomized crossover design, stable PD patients were treated with AlaGln (8 mM) or placebo added to PD fluid for eight weeks. As primary outcome measures, dialysate cancer-antigen 125 (CA-125) appearance rate and ex vivo stimulated interleukin-6 (IL-6) release were assessed in peritoneal equilibration tests. In 8 Austrian centers, 54 patients were screened, 50 randomized, and 41 included in the full analysis set. AlaGln supplementation significantly increased CA-125 appearance rate and ex vivo stimulated IL-6 release. AlaGln supplementation also reduced peritoneal protein loss, increased ex vivo stimulated tumor necrosis factor (TNF)-α release, and reduced systemic IL-8 levels. No adverse safety signals were observed. All 4 peritonitis episodes occurred during standard PD fluid treatment. A novel AlaGln-supplemented PD fluid improves biomarkers of peritoneal membrane integrity, immune competence, and systemic inflammation compared to unsupplemented PD fluid with neutral pH and low-glucose degradation. A phase 3 trial is needed to determine the impact of AlaGln supplementation on hard clinical outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Peritonitis / Soluciones para Diálisis / Diálisis Peritoneal / Dipéptidos / Fallo Renal Crónico Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Kidney Int Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Peritonitis / Soluciones para Diálisis / Diálisis Peritoneal / Dipéptidos / Fallo Renal Crónico Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Kidney Int Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos