Echocardiographic, electrocardiographic and blood pressure changes induced by icodextrin solution in diabetic patients on peritoneal dialysis.

The use of icodextrin as an osmotic agent in solutions for peritoneal dialysis (PD) has important cardiovascular effects related with better control of extracellular volume. Among them, reduction of arterial pressure and an improvement in echocardiographic parameters stand out. In diabetic patients, icodextrin has additional potential advantages related with better metabolic control. In a multicenter, open-label randomized controlled trial, the effects of icodextrin solutions were compared to glucose solutions on echocardiographic, electrocardiographic, and blood pressure changes in diabetic patients on PD. Two phases were noted in the follow-up. In the early phase (6 months), reduction in ambulatory blood pressure (ABP) and left ventricular end diastolic diameter were found in the icodextrin group. These changes correlated with changes in body fluids. In the late phase (12 months), a trend towards baseline values in ABP was seen. Changes in inferior vena cava diameter and in low frequency R-R variability spectral analysis in the icodextrin group suggest that icodextrin increases circulating blood volume and sympathetic tone, probably by accumulation of icodextrin metabolites in the bloodstream and improvement in diabetic neuropathy as a result of lower peritoneal glucose absorption. The effects of icodextrin in diabetic patients were related to better fluid management and metabolic control.

Increments in whole body bone mineral content associated with weight and length in pre-term and full-term infants during the first 6 months of life.

BACKGROUND: The objective of the present study was to assess bone mineral content (BMC) of the whole skeleton in pre-term and full-term healthy infants and the factors influencing BMC, such as bone area, birth weight, birth length, current weight, current length, gender, and gestational age. METHODS: Forty-eight healthy full-term infants and 34 healthy premature infants fed predominantly with intact human milk were studied. BMC was measured monthly with dual energy X-ray absorptiometry (DEXA). At the same time, length and weight were measured and registered. Pre-term infants were studied at 60-day intervals. RESULTS: For both full-term and pre-term infants, BMC increased during the first months of life. However, the values of pre-term infants never reached the values of full-term infants, even after correcting for age and weight. For both full-term and pre-term infants, BMC was significantly correlated at the second month with birth weight (r = 0.901), birth length (r = 0.860), gestational age (r = 0.803), bone area (r = 0.960), current weight (r = 0.920), and current length (r = 0.840, p <0.001 for all correlation coefficients). Multivariate analysis revealed that bone area was the most important factor in predicting BMC. CONCLUSIONS: Pre-term children have lower BMC than full-term children. The main factor explaining this apparent osteopenia is bone area. Pre-term children have a higher daily mineralization rate than full-term children, but this catch-up mineralization is not enough to reach BMC levels seen in full-term children.

Cola beverage consumption induces bone mineralization reduction in ovariectomized rats.

BACKGROUND: A significant association of cola beverage consumption and increased risk of bone fractures has been recently reported. The present study was carried out to examine the relationship of cola soft drink intake and bone mineral density in ovariectomized rats. METHODS: Study 1. Four groups of 10 female Sprague-Dawley rats were studied. Animals from groups II, III, and IV were bilaterally ovariectomized. Animals from groups I and II received tap water for drinking, while animals from groups III and IV each drank a different commercial brand of cola soft drink. After 2 months on these diets, the following were measured: solid diet and liquid consumption; bone mineral density; calcium in bone ashes; femoral cortex width; calcium; phosphate; albumin; creatinine; alkaline phosphatase; 25-OH hydroxyvitamin D, and PTH. RESULTS: Study 2. Two groups of seven ovariectomized rats were compared. Group A animals received the same management as the group III animals from study 1 (cola soft drink and rat chow ad libitum), while rats from group B received tap water for drinking and pair-feeding. After 2 months plasmatic ionized calcium, phosphate, creatinine, albumin, calcium in femoral ashes, and femoral cortex width were measured. Study 1. Rats consuming cola beverages (groups III and IV) had a threefold higher liquid intake than rats consuming water (groups I and II). Daily solid food intake of rats consuming cola soft drinks was one-half that of rats consuming water. Rats consuming soft drinks developed hypocalcemia and their femoral mineral density measured by DEXA was significantly lower than control animals as follows: group I, 0.20 +/- 0.02; group II, 0.18 +/- 0.01; group III, 0.16 +/- 0.01, and group IV, 0.16 +/- 0.01 g/cm(2). Study 2. To rule out the possibility that these calcium and bone mineral disorders were caused by decreased solid food intake, a pair-fed group was studied. Despite a lower body weight, pair-fed animals consuming tap water did not develop bone mineral reduction or hypocalcemia. CONCLUSIONS: These data suggest that heavy intake of cola soft drinks has the potential of reducing femoral mineral density.