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Clinical Trial
. 2021 Apr 2;22(7):3732.
doi: 10.3390/ijms22073732.

The Effect of Far-Infrared Therapy on the Peritoneal Expression of Glucose Degradation Products in Diabetic Patients on Peritoneal Dialysis

Chia-Ning Chang  1   2   3 , Chih-Yuan Niu  4   5 , Ann Charis Tan  6 , Chia-Hao Chan  6 , Chun-Fan Chen  4   5   7 , Tz-Heng Chen  4   5   6   8 , Szu-Yuan Li  4   5   6 , Yung-Tai Chen  4   5   9   10 , Fan-Yu Chen  4   5   6 , Wen-Sheng Liu  1   2   4   5   10   11 , Chih-Ching Lin  4   5   6 , Guor-Jien Wei  1   2   12
Affiliations
Clinical Trial

The Effect of Far-Infrared Therapy on the Peritoneal Expression of Glucose Degradation Products in Diabetic Patients on Peritoneal Dialysis

Chia-Ning Chang et al. Int J Mol Sci. .

Abstract

Peritoneal dialysis (PD) is a treatment modality for end-stage renal disease (ESRD) patients. Dextrose is a common osmotic agent used in PD solutions and its absorption may exacerbate diabetes mellitus, a common complication of ESRD. PD solutions also contain glucose degradation products (GDPs) that may lead to encapsulating peritoneal sclerosis (EPS), a severe complication of PD. A previous study showed that far-infrared (FIR) therapy improved a patient's gastrointestinal symptoms due to EPS. Due to limited literature on the matter, this study aims to investigate dialysate GDPs and peritoneal function in diabetic patients on PD. Thirty-one PD patients were enrolled and underwent 40 min of FIR therapy twice daily for six months. We demonstrated the effect of FIR therapy on the following: (1) decrease of methylglyoxal (p = 0.02), furfural (p = 0.005), and 5-hydroxymethylfurfural (p = 0.03), (2) increase of D/D0 glucose ratio (p = 0.03), and (3) decrease of potassium levels (p = 0.008) in both DM and non-DM patients, as well as (4) maintenance and increase of peritoneal Kt/V in DM and non-DM patients, respectively (p = 0.03). FIR therapy is a non-invasive intervention that can decrease dialysate GDPs in PD patients by improving peritoneal transport rate and solute removal clearance, while also maintaining dialysis adequacy.

Keywords: diabetes mellitus; far-infrared therapy; glucose degradation products; peritoneal dialysis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of study participants to compare the effect of FIR therapy on DM and non-DM patients. Abbreviations: FIR: far-infrared; DM: diabetes mellitus; GDP: glucose degradation products.
Figure 2
Figure 2
Chromatograms of GDP-DNPH hydrazone derivatives using UPLC-PDA method. The x-axis represents retention time and the y-axis represents UV absorption. (A) GDP-DNPH standard solution at UV absorption 360 nm. (B) GDP-DNPH standard solution at UV absorption 430 nm. (C) GDP-DNPH in dialysate samples at UV absorption 360 nm. (D) GDP-DNPH in dialysate samples at UV absorption 430 nm. Abbreviations: GDP: glucose degradation products; DNPH: 2,4-dinitrophenylhydrazine; UPLC-PDA: ultra-performance liquid chromatography photodiode array; UV: ultraviolet.
Figure 2
Figure 2
Chromatograms of GDP-DNPH hydrazone derivatives using UPLC-PDA method. The x-axis represents retention time and the y-axis represents UV absorption. (A) GDP-DNPH standard solution at UV absorption 360 nm. (B) GDP-DNPH standard solution at UV absorption 430 nm. (C) GDP-DNPH in dialysate samples at UV absorption 360 nm. (D) GDP-DNPH in dialysate samples at UV absorption 430 nm. Abbreviations: GDP: glucose degradation products; DNPH: 2,4-dinitrophenylhydrazine; UPLC-PDA: ultra-performance liquid chromatography photodiode array; UV: ultraviolet.
Figure 3
Figure 3
FIR therapy set-up during a PD exchange. Abbreviation: FIR: far-infrared; PD: peritoneal dialysis.
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