Peritoneal Membrane Preservation.
Peritoneal dialysis (PD) is a successfully used method for renal replacement therapy. However, long-term PD may be associated with peritoneal fibrosis and ultrafiltration failure. The key factors linked to their appearance are repeated episodes of inflammation associated with peritonitis and long-term exposure to bioincompatible PD fluids. Different strategies have been proposed to preserve the peritoneal membrane. This article reviews the functional and structural alterations related to PD and strategies whereby we may prevent them to preserve the peritoneal membrane. The use of new, more biocompatible, PD solutions is promising, although further morphologic studies in patients using these solutions are needed. Blockade of the renin-angiotensin-aldosterone system appears to be efficacious and strongly should be considered. Other agents have been proven in experimental studies, but most of them have not yet been tested appropriately in human beings.
Home Dialysis Unit, Nephrology Department, La Paz University Hospital, Madrid, Spain. Electronic address: mauxiliadora.bajo@salud.madrid.org.
M Auxiliadora
MA
Bajo
University Autónoma of Madrid, Hospital La Paz Institute for Health Research, Spanish Renal Research Network, Reina Sofia Institute for Nephrology Research, Madrid, Spain.
Gloria
G
Del Peso
Home Dialysis Program, University of Colorado Hospital, University of Colorado School of Medicine, Aurora, CO.
Isaac
I
Teitelbaum
D015314:Dialysis Solutions / Q000627:therapeutic use*; D058750:Epithelial-Mesenchymal Transition; D006801:Humans; D007249:Inflammation; D007676:Kidney Failure, Chronic / Q000628:therapy*; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods*; D056627:Peritoneal Fibrosis / Q000209:etiology / Q000517:prevention & control*; D010537:Peritoneum; D010538:Peritonitis
D015314:Dialysis Solutions
Peritoneal dialysis; peritoneal fibrosis; peritoneal membrane; preventive measures; therapeutic interventions