SIMULTANEOUS INCREASE IN ULTRAFILTRATION VOLUME AND SODIUM REMOVAL WITH STEADY CONCENTRATION PERITONEAL DIALYSIS USING CARRY LIFE UF

8 Feb 2025 12 a.m. 12 a.m.
WCN25-AB-917, Poster Board= SAT-584

Introduction:

Achieving adequate ultrafiltration (UF) as well as sodium removal is a challenge with peritoneal dialysis (PD), especially during automated PD (APD) as a result of sodium sieving. Carry Life UF is a novel PD system, using steady concentration peritoneal dialysis (SCPD), that is potentially suitable for PD patients requiring enhanced fluid removal. The Carry Life UF device transfers small amounts of dialysate between the patient and the device, while continuously adding glucose to achieve a stable intraperitoneal glucose concentration during the treatment. The aim of this study was to investigate ultrafiltration, sodium removal and glucose efficiency using Carry Life UF.

Methods:

Eight stable PD patients were included in the study. Subjects were treated with 5-hour Carry Life UF treatments using three different glucose doses (11, 14, 20 g/h). An initial fill with 1500 ml, 1.36% glucose PD solution was used. A small volume of dialysate was drained hourly to avoid overfill. A standard 4-hour 2.27% glucose CAPD dwell was used as control. UF volume, sodium removal, and glucose absorption was calculated as well as glucose efficiency for UF (ml UF volume/g glucose absorbed), and for sodium removal (mmol sodium removed/g glucose absorbed). Data expressed as mean ± SD, statistical analysis using one-way ANOVA, *p<0.05, **p<0.01, ***p<0.001.

Results:

As showed in the table, compared to the control, there was an increase in UF for all Carry Life treatments, as well as a proportional increase in sodium removal. Glucose absorption increased during the Carry Life UF treatments compared to the control, however, the glucose UF efficiency was increased with Carry Life UF. Further, an increased sodium removal per absorbed gram of glucose was noted, which was statistically significant for the Carry Life UF 11 g/h and the 14 g/h glucose doses. The figure shows a strong positive correlation between UF volume and sodium removal for the Carry Life UF treatments, r2=0.967.

           

Treatment

UF volume (ml/dwell)

Sodium removal (mmol/dwell)

Glucose absorption (g/dwell)

Glucose UF efficiency (ml/g absorbed glucose)

Glucose sodium removal efficiency (mmol/g absorbed glucose)

Control (2.27% glucose CAPD dwell)

162±242

21±33

32±4.2

5.9±7.8

0.78±1.04

Carry Life UF  11 g/h

646±256***

86±27***

43±9.3**

17.0±10.6**

2.23±1.20**

Carry Life UF  14 g/h

739±312***

92±33***

53±4.4***

14.5±7.7**

1.80±0.82*

Carry Life UF  20 g/h

863±380***

110±37***

73±7.1***

12.4±6.8*

1.57±0.69

Conclusions:

The simultaneous increase in UF volume and sodium removal with SCPD compared to the control is a clinical benefit. The increased UF volume with the Carry Life UF treatment compared to control, was associated with an increased glucose absorption which, however, was not proportional to the increase in UF. Hence, the glucose UF efficiency was significantly higher with the Carry Life UF treatment compared to control. Also, the glucose sodium removal efficiency was increased with the Carry Life UF treatments. The linear correlation between UF volume and sodium removal with SCPD is in contrast to the situation with APD, where an increased UF volume does not result in a proportional increase in sodium removal. In conclusion, SCPD performed with the Carry Life UF system resulted in higher UF, greater and predictable sodium removal and more efficient use of glucose, both with respect to UF and sodium removal, and may be a feasible way to improve quality of care for PD patients.
Trial registration number: NCT03724682 (ClinicalTrials.gov).

I have potential conflict of interest to disclose.
O. Carlsson and C. de Leon report employment with Triomed AB. J. Hegbrant reports employment with JBA Medical AB; consultancy for Triomed AB and myjoju Ltd; ownership interest in LundaTec AB, NorrDia AB, Redsense Medical AB, and Triomed AB; and advisory or leadership roles for Board of Directors of NorrDia AB. O. Heimbürger reports research funding from AstraZeneca, Baxter, and Triomed; honoraria from AstraZeneca, Baxter Healthcare, Fresenius Medical Care, and Vifor for presentations at company-organized courses; speakers bureau for AstraZeneca; and other interests or relationships as Secretary of Swedish Society of Renal Medicine (2021); and role on Editorial Boards of Blood Purification, Clinical Nephrology, Peritoneal Dialysis International, and Turkish Journal of Nephrology. M. Wilkie reports consultancy for Triomed, research funding from Baxter, honoraria from Baxter and Fresenius, speakers bureau for Baxter, and other interests or relationships with International Society for Peritoneal Dialysis.

I did not use generative AI and AI-assisted technologies in the writing process.