title: Effect of neutral pH and low-glucose degradation product-containing peritoneal dialysis solution on residual renal function in peritoneal dialysis patients: a meta-analysis.
abstract: BACKGROUND
  Glucose degradation products (GDPs) in peritoneal dialysis (PD) solution (PDS) have been shown to inflict damage to the kidney, which is the major organ for advanced glycosylation end product elimination. Hence, this study investigated whether new PDSs with neutral pH and low-GDPs have a beneficial effect on the preservation of residual renal function (RRF) among PD patients.
  
  
  METHODS
  Randomized controlled trials examining the effect of neutral pH and low-GDP PDSs on RRF in PD patients >18 years old compared with conventional PDSs were selected. The modality of PD treatment was continuous ambulatory PD. The primary outcome variable was mean RRF value. Weekly Kt/V, urine volume, peritoneal ultrafiltration, blood pressure and all-cause mortality of PD patients were measured as secondary outcome variables.
  
  
  RESULTS
  We identified 6 randomized controlled trials and found that patients using low-GDP PDSs had a much slower rate of RRF loss compared with patients using conventional PDSs [mean difference (MD) = 0.45, 95% confidence intervals (CI) 0.10-0.80, p = 0.01]. In addition, weekly Kt/V was markedly improved in the low-GDP PDS group (MD = 0.13, 95% CI 0.06-0.21, p = 0.0005), and urine volume was increased (MD = 110.34, 95% CI 8.58-212.10, p = 0.03). No significant differences were observed between the two groups with respect to peritoneal ultrafiltration, blood pressure and risk of all-cause mortality.
  
  
  CONCLUSIONS
  Our meta-analysis demonstrates a significant benefit of using low-GDP PDSs for RRF preservation in PD patients. Further trials are needed to determine whether this beneficial effect can affect long-term clinical outcomes.
authors.affiliation: Department of Nephrology, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai, China.
authors.forename: Jialin
authors.initials: J
authors.lastname: Wang
authors.forename: Nan
authors.initials: N
authors.lastname: Zhu
authors.forename: Weijie
authors.initials: W
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D015314:Dialysis Solutions / Q000737:chemistry* / Q000494:pharmacology*; D005260:Female; D005947:Glucose / Q000737:chemistry*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods*; D016032:Randomized Controlled Trials as Topic
chemical_list: D015314:Dialysis Solutions; D005947:Glucose