Saccharides as osmotic agents in peritoneal dialysate: determination of molecular weight essential for more efficient fluid removal

Adv Perit Dial. 1998:14:40-3.

Abstract

Glucose has widely been used as an osmotic agent in continuous ambulatory peritoneal dialysis (CAPD) but owing to its low molecular weight (MW), ultrafiltration (UF) in a 6-hour dialysate exchange does not appear sufficient. Thus, in the present study, a search was made to find saccharides that would ensure optimal UF, exceeding that obtained with glucose in a 6-hour dwell period. Rats were intraperitoneally infused with peritoneal dialysate (20 mL/body) containing the same molar concentrations (75.5 mM, 126 mM, or 204 mM) of various osmotic agents including glucose (monosaccharide, MW = 180.16) at concentrations of 1.36%, 2.27%, and 3.86%; maltose (disaccharide, MW = 342.30) at concentrations of 2.58% and 4.32%; maltotriose (trisaccharide, MW = 504.44), at concentrations of 3.81% and 6.36%; and maltopentaose (pentasaccharide, MW = 828.72) at concentrations of 6.26% and 10.4%. Intraperitoneal-fluid volume was measured at 1, 2, 3, 4, and 6 hours. With glucose as the osmotic agent, maximal UF was noted at 2 to 4 hours. UF was more efficient at 6 hours with maltotriose or maltopentaose as the osmotic agent. Even with a trisaccharide or pentasaccharide (molecular weights of 500 to 830), UF at 6 hours was found more efficient, as evidenced by the delay in peritoneal absorption. Fluid removal in 6 hours should be greater when using a dialysate containing oligosaccharides such as maltotriose or maltopentaose in place of glucose.

MeSH terms

  • Animals
  • Blood Urea Nitrogen
  • Creatinine / metabolism
  • Dialysis Solutions / administration & dosage
  • Dialysis Solutions / chemistry*
  • Glucose / chemistry
  • Male
  • Maltose / chemistry
  • Molecular Weight
  • Oligosaccharides / chemistry*
  • Osmotic Pressure
  • Peritoneal Dialysis, Continuous Ambulatory*
  • Peritoneum / metabolism
  • Proteins / metabolism
  • Rats
  • Rats, Inbred Strains
  • Time Factors
  • Trisaccharides / chemistry

Substances

  • Dialysis Solutions
  • Oligosaccharides
  • Proteins
  • Trisaccharides
  • maltopentaose
  • maltotriose
  • Maltose
  • Creatinine
  • Glucose