title: Is there such a thing as biocompatible peritoneal dialysis fluid?
abstract: Introduction of the so-called biocompatible peritoneal dialysis (PD) fluids was based on a large body of experimental evidence and various clinical trials suggesting important clinical benefits. Of these, until now, only preservation of residual renal function-likely due to lower glucose degradation product load and, in case of icodextrin, improved fluid and blood pressure control-have consistently been proven, whereas the impact on important clinical endpoints such as infectious complications, preservation of PD membrane transport function, and patient outcome, are still debated. In view of the high morbidity and mortality rates of PD patients, novel approaches are warranted and comprise the search for alternative osmotic agents and enrichment of PD fluids with specific pharmacologic agents, such as alanyl-glutamine, potentially counteracting local but also systemic sequelae of uremia and PD.
authors.affiliation: Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany.
authors.forename: Claus Peter
authors.initials: CP
authors.lastname: Schmitt
authors.affiliation: Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. christoph.aufricht@meduniwien.ac.at.
authors.forename: Christoph
authors.identifier: 0000-0002-0487-4296
authors.initials: C
authors.lastname: Aufricht
mesh_terms: D001672:Biocompatible Materials / Q000737:chemistry / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D015314:Dialysis Solutions / Q000737:chemistry / Q000494:pharmacology*; D005947:Glucose / Q000378:metabolism; D006301:Health Services Needs and Demand; D006801:Humans; D000077607:Icodextrin / Q000494:pharmacology; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D009995:Osmosis / Q000187:drug effects; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010537:Peritoneum / Q000187:drug effects* / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D015314:Dialysis Solutions; D000077607:Icodextrin; D005947:Glucose
keywords: Alanyl-glutamine; Biocompatibility; Glucose degradation product; Icodextrin; Peritoneal dialysis