79558
document
Short-term studies on the use of glycerol as an osmotic agent in continuous ambulatory peritoneal dialysis ( CAPD ) . The use of glycerol as an osmotic agent in two different concentrations ( 92 mmol/l and 272 mmol/l ) in peritoneal dialysis fluid was investigated over 3 days in six patients on continuous ambulatory peritoneal dialysis and compared with two concentrations of glucose ( 76 mmol/l and 215 mmol/l ) in the same patients . The calorific value of the absorbed osmotic agent was lower , by 19 % with isotonic and 22 % with hypertonic solutions , when glycerol was used in place of glucose . However , glycerol provided significantly lower total ultrafiltration than glucose at each concentration , despite a higher initial osmotic pressure of the glycerol-based solutions . Thus , the higher concentration of glycerol required to provide equal ultrafiltration may offset any calorific advantage . Equilibration of creatinine and urea was slower and creatinine clearance lower with glycerol . Solutions containing glycerol were initially less acid ( pH 6.5 ) than those containing glucose ( pH 5.1 ) . Blood glycerol levels , which were in the physiological range with glucose as the osmotic agent , reached a peak 80-fold greater at 4.3 +/- 0.8 mmol/l during dialysis with fluid containing glycerol at 272 mmol/l and eightfold higher at 0.42 +/- 0.09 mmol/l with glycerol at 92 mmol/l . There was no evidence of haemolysis or other toxic effect despite these levels . The rise in blood glucose and insulin noted during the use of glucose-based solutions was not found with glycerol . Circulating levels of lactate , pyruvate , alanine , non-esterified fatty acids and the ketone bodies were similar with the two agents . Although these short-term studies have shown no conclusive advantage of glycerol over glucose , long-term effects of glycerol , particularly on circulating lipid levels , will determine its future role as an osmotic agent in continuous ambulatory peritoneal dialysis .
79559
Intervention_Pharmacological
glycerol
79560
Intervention_Pharmacological
glycerol
79561
Intervention_Control
glucose
79562
Intervention_Pharmacological
glycerol
79563
Intervention_Control
glucose
79564
Intervention_Pharmacological
glycerol
79565
Intervention_Pharmacological
glycerol
79566
Intervention_Pharmacological
glycerol
79567
Intervention_Pharmacological
glycerol
79568
Intervention_Pharmacological
glycerol
79569
Intervention_Pharmacological
glycerol
79570
Intervention_Control
glucose
79571
Intervention_Pharmacological
glycerol
79572
Outcome_Other
calorific value
79573
Outcome_Physical
total ultrafiltration
79574
Outcome_Other
equal ultrafiltration
79575
Outcome_Physical
Equilibration of creatinine and urea
79576
Outcome_Physical
creatinine clearance
79577
Outcome_Physical
Blood glycerol levels
79578
Outcome_Adverse-effects
haemolysis
79579
Outcome_Adverse-effects
toxic effect
79580
Outcome_Physical
blood glucose and insulin
79581
Outcome_Physical
Circulating levels of lactate
79582
Outcome_Physical
pyruvate
79583
Outcome_Physical
alanine , non-esterified fatty acids
79584
Outcome_Physical
the ketone bodies
79585
Outcome_Physical
circulating lipid levels
79586
Participant_Condition
continuous ambulatory peritoneal dialysis
79587
Participant_Condition
CAPD
79588
Participant_Sample-size
six
79589
Participant_Condition
continuous ambulatory peritoneal dialysis