Single daily overnight (12-h dwell) use of 7.5% glucose polymer (Mw 18700; Mn 7300) +0.35% glucose solution: a 3-month study

The osmotic effectiveness of an isosmolar glucose polymer (GP) solution during long-dwell (8-12 h) peritoneal dialysis has been demonstrated. The absorption of GP, though only a fraction of currently used glucose, is usually accompanied by the systemic accumulation of its breakdown product, maltose. The long-term consequences of maltose accumulation remain unknown. We studied the accumulation pattern of GP fractions, changes in serum electrolytes, osmolality, and adverse reaction profile over a 3-month period using a daily regime of an overnight exchange of 7.5% GP+0.35% glucose solution with three daytime exchanges of 1.36% glucose in five non-diabetic CAPD patients. The GP solution (299 +/- 0.7 mOsm/kg) produced mean daily overnight UF of 589 ml and maintained stable serum biochemistry. The mean serum maltose level increased from a predialysis value of 0.03 +/- 0.08 g/l to a steady-state level of 1.1 +/- 0.14 g/l within 2 weeks and remained stable throughout the study. This did not influence serum osmolality or sodium and produced no significant adverse effects. Once-daily overnight use of an isosmolar GP solution is safe and effective. The accumulation of maltose reaches steady-state levels quickly and produces no adverse toxic effects in the short term. Further long-term studies are planned.