Effects of peritoneal dialysis solutions low in GDPs on peritonitis and exit-site infection rates.
BACKGROUND
Peritoneal dialysis (PD) solutions sterilized at a low pH level contain only minimal amounts of glucose degradation products (GDPs). The latter are known to have an adverse effect on the peritoneal membrane. The present study retrospectively analyzes the effects on the incidences of peritonitis and exit-site infections.


METHODS
Data concerning the frequency of peritonitis and exit-site infections for 120 patients treated with PD were collected. Before 2000, 67 of these patients received conventional dialysates and from 2000 on, 53 patients were treated with the new dialysis fluids. Furthermore, a correlation between the incidence of infections and the duration of treatment with dialysis was established.


RESULTS
It was observed that the use of dialysis solutions low in GDPs resulted in significantly lower rates of peritonitis (p = 0.002) and exit-site infections (p = 0.02). When using the new treatment, peritonitis occurred, on average, after 48 months of treatment and exit-site infections after 34 months of treatment.


CONCLUSIONS
The result supports the hypothesis that the use of the new, biocompatible, PD solutions contributes to considerable reduction in the rates of peritonitis and exit-site infections. As it is not expected that randomized prospective studies will be conducted in the future, further observational studies should be carried out in order to affirm the observed tendencies.
Furkert
Jürgen
J
Nephrology and Gastroenterology, SLK-Kliniken Heilbronn, Bad Friedrichshall, Germany. juergen.furkert@slk-kliniken.de
Zeier
Martin
M
Schwenger
Vedat
V
D000328:Adult; D002408:Catheters, Indwelling / Q000382:microbiology; D003928:Diabetic Nephropathies / Q000628:therapy; D015314:Dialysis Solutions / Q000737:chemistry*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects; D010538:Peritonitis / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control
D015314:Dialysis Solutions; D005947:Glucose