Estimating glucose absorption in peritoneal dialysis using peritoneal equilibration tests.

To determine peritoneal dialysis patients' dietary energy requirements, the glucose absorbed from the dialysate needs to be quantified. The currently accepted method of estimating glucose absorption is based on the average glucose absorption of 7 continuous ambulatory peritoneal dialysis (CAPD) patients (Grodstein, 1981). Peritoneal equilibration test curves have shown that modality and transport characteristics affect glucose absorption. To test a more accurate procedure for estimating glucose absorption, we compared two different methods of determining the actual glucose absorption: Grodstein formula: (11.3 xa-10.9) liters of dialysate, where xa is the average glucose concentration, and the D/D0 formula: (1-D/D0)xi, where xi is the initial glucose instilled, using 4-hour D/D0 for CAPD and dwell time D/D0 for automated peritoneal dialysis (APD). Twenty-four-hour glucose absorption was measured in 50 CAPD patients and 17 APD patients. Absorption was calculated from the glucose remaining in the 24-hour spent dialysate. Wilcoxon sign rank statistical analysis showed the D/D0 formula results to be closer to actual glucose absorbed (CAPD: p = 0.0153; APD: p = 0.0001). The D/D0 formula is individualized for patients' modality and membrane characteristics and easy to calculate from readily available information.

MAb 170H.82: an evaluation of a novel panadenocarcinoma monoclonal antibody labelled with 99Tcm and with 111In.

A novel method for generating monoclonal antibodies against synthetic tumour-associated glycoconjugates has been developed. One of these monoclonal antibodies, designated 170H.82, was derived against the TF antigen and has been shown in vitro to have a wide range of reactivity with adenocarcinoma. This antibody has been labelled with 111In and 99Tcm and has been evaluated in pilot clinical trials involving 48 patients with a range of adenocarcinoma. Overall clinical accuracy with the radiolabelled antibody was 92%, with the antibody appearing to have particular clinical utility in gynaecological and breast cancers. Single photon emission computed tomographic (SPECT) imaging was shown to improve the quality of the images and to improve the diagnostic sensitivity. We believe that this unique antibody, labelled with 99Tcm, appears to offer promise for routine clinical use in the evaluation of patients with a range of primary and metastatic adenocarcinoma.