PubMed · 15197893
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Masami Imai, Takehiro Kobayashi. 2004. [Dialysis machine].. https://pubmed.ncbi.nlm.nih.gov/15197893/
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When using capillary electrophoresis (CE) for the analysis of biological samples, it is often necessary to employ techniques to overcome peak-broadening that results from having a high-conductivity sample matrix. To improve the concentration detection limits and separation efficiency of cationic pharmaceuticals in CE, pH-mediated acid stacking was performed to electrofocus the sample, improving separation sensitivity for the analyzed cations by 60-fold. However, this method introduces a large titrated acid plug into the capillary. To overcome the limitations this low-conductivity plug poses to stacking, the plug was removed prior to the separation step by applying reverse pressure to force it out of the anode of the capillary. Employing this technique allows for roughly twice the volume of sample to be injected. A maximum sample injection time of 240 s was attainable with baseline peak resolution compared to a maximum sample injection time of 120 s without reverse pressure, leading to a twofold decrease in the limits of detection of the analytes used. Separation efficiency overall is also improved when utilizing the reverse pressure step. For example, a 60 s sample injection time results in 94,000 theoretical plates as compared to 60,500 theoretical plates without reverse pressure. This reverse-pressure method was used for detection and quantitation of several cationic pharmaceuticals that were prepared in Ringer's solution to simulate microdialysis sampling conditions.
Several clinical observations suggest the superiority of icodextrin compared with 4.25% dextrose in optimizing peritoneal ultrafiltration (UF), but no rigorous controlled evaluation has hitherto been performed. For comparing icodextrin and 4.25% dextrose during the long dwell of automated peritoneal dialysis, a multicenter, randomized, double-blind trial was conducted in 92 patients (control, 45; icodextrin, 47) with 4-h dialysate to plasma ratio creatinine >0.70 and D/D(0) glucose <0.34. Long-dwell net UF and the UF efficiency ratio (net UF volume per gram of dialysate carbohydrate absorbed) were determined at baseline, week 1, and week 2. The control and treatment groups were comparable at baseline (all patients using 4.25% dextrose for the long dwell) with regard to mean (+/-SEM) net UF (201.7 +/- 103.1 versus 141.6 +/- 75.4 ml, respectively; P = 0.637) and the percentage of patients with negative net UF (control, 37.8%; treatment, 42.6%; P = 0.641). During the study period, net UF was unchanged from baseline in the control group but increased significantly (P < 0.001) in the icodextrin group from 141.6 +/- 75.4 to 505.8 +/- 46.8 ml at week 1 and 540.2 +/- 46.8 ml at week 2. In the icodextrin group, the incidence of negative net UF was significantly lower (P < 0.0001) than in the control group. Findings were similar for UF efficiency ratio. Rash was reported significantly more often in the icodextrin group. This study showed that in high-average and high transporters, icodextrin is superior to 4.25% dextrose for long-dwell fluid and solute removal.
BACKGROUND: Transferrin binds extracellular iron and protects tissues from iron-induced oxidative stress. The binding of iron and transferrin is pH dependent and conventional peritoneal dialysis (PD) solutions have unphysiologically low pH values. Herein, we investigated whether conventional PD solution releases iron from transferrin and if the released iron causes oxidative stress. METHODS: Effects of PD solutions on iron binding to transferrin were examined with purified human transferrin and transferrin in dialysates drained from PD patients. Oxidative stress induced by iron released from transferrin was evaluated in terms of the formation of thiobarbituric acid reactive substance (TBARS) and protein carbonylation in the human red blood cell (RBC) membrane. The iron deposition in peritoneal tissue from PD patients was evaluated by Perls' staining with diaminobenzidine intensification. RESULTS: Low pH PD solution released iron from transferrin. This iron release occurred within 1 min. Iron release was not observed in neutralized PD solution. Iron released from transferrin in low pH PD solution increased TBARS formation and protein carbonylation in the human RBC membrane. Iron deposition, which is prominent in the fibrotic area facing the peritoneal cavity, was observed in the peritoneum of PD patients. CONCLUSIONS: Iron released from transferrin in low pH PD solution can produce oxidative stress in the peritoneum of a PD patient. Neutralizing PD solution can avoid this problem. Iron deposition in the peritoneum may participate in the pathogenesis of peritoneal fibrosis in PD patients.