A Simple Method to Determine Blood Concentration of Oligosaccharides in Peritoneal Dialysis Patients Using Icodextrin

摘要

Icodextrin (ICO) diaLysate is known to improve ultra-filtration during the long dwellin peritoneal dialysis (PD) patients (1-3) and is absorbed to the systemic circulation mainly via lymphatic vessels. Details of the physiologic effects of oligosaccharides degraded from ICO in blood remain unclear. Although high performance liquid chromatography (HPLC) methods have been used to determine blood concentrations of oligosaccharides (4-7), HPLC techniques are cumbersome, expensive, and time-consuming and consequently hinder repeated measurements for further research on ICO. On the other hand, self-monitoring of blood glucose (SMBG) instruments using glucose dehydrogenase (GDH) are known to yield incorrect values of blood glucose because the enzyme cross-reacts with those oligosaccharides (8-10). We therefore devised a rapid easy-to-use method for estimating blood concentrations of oligosaccharides, making use of the errors in measurement by SMBG in PD patients receiving ICO. In addition, changes in totalcon-centrations of oligosaccharides in blood over time were estimated for 24 hours after initiation of the ICO dwell in new patients receiving continuous ambulatory peritoneal dialysis (CAPD).