title: Does the use of neutral pH, low glucose degradation product peritoneal dialysis fluids lead to better patient outcomes?
abstract: OBJECTIVE
  This review will examine the impact of neutral pH, low glucose degradation product (GDP) peritoneal dialysis fluid use on patient-level clinical outcomes in peritoneal dialysis patients.
  
  
  RESULTS
  Recently published results from the balANZ trial and a meta-analysis suggest that the use of neutral pH, low GDP peritoneal dialysis fluids leads to better preservation of residual renal function, including residual diuresis, without added harmful effects. The impact of neutral pH, low GDP peritoneal dialysis fluids on other clinical outcomes (e.g. peritonitis) remains uncertain due to conflicting results from randomized controlled trials. A meta-analysis was unable to clarify this further due to generally suboptimal trial quality and insufficient statistical power.
  
  
  CONCLUSIONS
  At present, based on the best available evidence, the use of neutral pH, low GDP peritoneal dialysis fluids is associated with some important clinical benefits without added harm. Further studies in the area are needed to establish the cost-effectiveness of this therapy and to clarify the effects of biocompatible fluids on patient-level outcomes, such as peritonitis, quality of life, technique survival and patient survival.
authors.affiliation: aDepartment of Renal Medicine, Princess Alexandra Hospital bSchool of Medicine cTranslational Research Institute, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Yeoungjee
authors.initials: Y
authors.lastname: Cho
authors.forename: David W
authors.initials: DW
authors.lastname: Johnson
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000378:metabolism*; D015314:Dialysis Solutions / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007668:Kidney / Q000378:metabolism* / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D015314:Dialysis Solutions