title: Peritoneal dialysis and inflammation.
abstract: Peritoneal dialysis (PD) is a kidney replacement therapy for end stage renal disease (ESRD) patients. Despite being a lifesaving treatment, the rate of mortality in patients under PD is elevated, mainly due to the chronic peritoneal dysfunction which is characterized by inflammation, peritoneal fibrosis and neoangiogenesis. The inflammatory process is trigged and modulated by the type of the peritoneal dialysis solutions (PDSs) used during PD. Currently, different PDSs are commercially available: (i) the conventional solutions; (ii) solutions of neutral pH containing low concentration of glucose degradation products (GDPs); (iii) solutions with icodextrin; and (iv) solutions containing taurine. Therefore, the aim of this review is to describe the different types of peritoneal dialysis solutions used during PD and their relationship with systemic and intraperitoneal inflammation. Some studies suggested that solutions of neutral pH containing low concentration of GDPs, icodextrin and taurine have better biocompatibility and lower influence on the inflammatory process compared to the conventional one. On the other hand, the studies, in general, were performed with a small population and for a short period of time. Therefore, further well-designed and -controlled clinical trials with larger number of individuals are required in order to better understand the role of different peritoneal dialysis solution types in the development of inflammation in patients with chronic peritoneal dialysis. Accordingly, studies that are more well-designed, well-controlled and with a larger number of patients are needed to explain and define the role of different types of PDS in the inflammation development in patients with chronic peritoneal dialysis.
authors: Campus Centro Oeste Dona Lindu, Federal University of São João del-Rei, Brazil.
authors: Marina Souza Silva
authors: MS
authors: Velloso
authors: Campus Centro Oeste Dona Lindu, Federal University of São João del-Rei, Brazil.
authors: Alba
authors: A
authors: Otoni
authors: Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Brazil.
authors: Adriano
authors: A
authors: de Paula Sabino
authors: Campus Centro Oeste Dona Lindu, Federal University of São João del-Rei, Brazil.
authors: Whocely Victor
authors: WV
authors: de Castro
authors: Sao Joao de Deus Hospital, Brazil.
authors: Sérgio Wyton Lima
authors: SW
authors: Pinto
authors: Sao Joao de Deus Hospital, Brazil.
authors: Maria Aparecida Silva
authors: MA
authors: Marinho
authors: Campus Centro Oeste Dona Lindu, Federal University of São João del-Rei, Brazil. Electronic address: danyelleromana@gmail.com.
authors: Danyelle Romana Alves
authors: DR
authors: Rios
mesh_terms: D015314:Dialysis Solutions / Q000009:adverse effects* / Q000737:chemistry; D005936:Glucans / Q000009:adverse effects; D005947:Glucose / Q000009:adverse effects / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D000077607:Icodextrin; D007249:Inflammation / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology; D007674:Kidney Diseases / Q000150:complications / Q000628:therapy; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010537:Peritoneum / Q000187:drug effects / Q000473:pathology; D013654:Taurine / Q000009:adverse effects; D014462:Ultrafiltration
chemical_list: D015314:Dialysis Solutions; D005936:Glucans; D013654:Taurine; D000077607:Icodextrin; D005947:Glucose
keywords: Inflammation; Peritoneal dialysis; Peritoneal dialysis solutions