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SHR Neuro Cancer Cardio Lipid Metab Microb

Vychytil, A; Herzog, R; Probst, P; Ribitsch, W; Lhotta, K; Machold-Fabrizii, V; Wiesholzer, M; Kaufmann, M; Salmhofer, H; Windpessl, M; Rosenkranz, AR; Oberbauer, R; König, F; Kratochwill, K; Aufricht, C.
A randomized controlled trial of alanyl-glutamine supplementation in peritoneal dialysis fluid to assess impact on biomarkers of peritoneal health.
Kidney Int. 2018; 94(6): 1227-1237. Doi: 10.1016/j.kint.2018.08.031 [OPEN ACCESS]
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Co-authors Med Uni Graz: Ribitsch Werner; Rosenkranz Alexander
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Abstract:: 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. Copyright © 2018 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
Find related publications in this database (Keywords): biocompatibility; glutamine; host defense; peritoneal immune competence; peritoneal inflammation; stress response