New Peritoneal Dialysis Solutions and Solutions on the Horizon

Feriani, M; Krediet, Raymond T.

doi:10.1007/978-0-387-78940-8_11

Cited by 2 publications

(1 citation statement)

References 169 publications

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“…However, benefits of low-GDP fluids are biologically plausible, as GDPs have been demonstrated to exert direct nephrotoxic effects on renal tubular cells. 41 Although currently available neutral-pH, low-GDP fluids vary considerably in their GDP contents, 13,42,43 the bulk of the studies analyzed used one particular solution (Balance, Fresenius Medical Care, Bad Homburg, Germany), 15,24,25,34,37,38 such that comparison of the renoprotective benefits of different neutral-pH, low-GDP solutions was not possible.…”

Section: Discussionmentioning

confidence: 99%

The impact of neutral-pH peritoneal dialysates with reduced glucose degradation products on clinical outcomes in peritoneal dialysis patients

Cho

Johnson

Badve

et al. 2013

Kidney International

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Neutral-pH peritoneal dialysates, with reduced glucose degradation products (GDPs), have been developed to reduce peritoneal membrane damage. Here our review evaluated the impact of these solutions on clinical outcomes using data from The Cochrane CENTRAL Registry, MEDLINE, Embase, and reference lists for randomized trials of biocompatible solutions. Summary estimates of effect were obtained using a random-effects model of 20 eligible trials encompassing 1383 patients. The quality of studies was generally poor, such that 13 studies had greater than a 20% loss to follow-up and only 3 trials reported adequate concealment of allocation. Use of neutral-pH dialysates with reduced GDPs resulted in larger urine volumes (7 trials; 520 patients; mean difference 126 ml/day, 95% CI 27-226), improved residual renal function after 12 months (6 trials; 360 patients; standardized mean difference 0.31, 95% confidence interval 0.10-0.52), and a trend to reduced inflow pain (1 trial; 58 patients; relative risk 0.51, 95% CI 0.24-1.08). However, there was no significant effect on body weight, hospitalization, peritoneal solute transport rate, peritoneal small-solute clearance, peritonitis, technique failure, patient survival, or adverse events. No significant harms were identified. Thus, based on generally poor quality trials, the use of neutral-pH peritoneal dialysates with reduced GDPs resulted in greater urine volumes and residual renal function after 12 months, but without other clinical benefits. Larger, better-quality studies are needed for accurate evaluation of the impact of these newer dialysates on patient-level hard outcomes.

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Section: Discussionmentioning

confidence: 99%

The impact of neutral-pH peritoneal dialysates with reduced glucose degradation products on clinical outcomes in peritoneal dialysis patients

Cho

Johnson

Badve

et al. 2013

Kidney International

View full text Add to dashboard Cite

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Biocompatible dialysis fluids for peritoneal dialysis

Cho

Johnson

Craig

et al. 2014

Cochrane Database of Systematic Reviews

115

108

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Based on generally sub-optimal quality studies, use of neutral pH, low GDP PD solution led to greater urine output and higher residual renal function after use exceeded 12 months. Icodextrin prescription improved peritoneal ultrafiltration and mitigated uncontrolled fluid overload. There were no significant effects on peritonitis, technique survival, patient survival or harms identified with their use. Based on the best available evidence, the use of these 'biocompatible' PD solutions resulted in clinically relevant benefits without added risks of harm.

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New Peritoneal Dialysis Solutions and Solutions on the Horizon

Cited by 2 publications

References 169 publications

The impact of neutral-pH peritoneal dialysates with reduced glucose degradation products on clinical outcomes in peritoneal dialysis patients

The impact of neutral-pH peritoneal dialysates with reduced glucose degradation products on clinical outcomes in peritoneal dialysis patients

Biocompatible dialysis fluids for peritoneal dialysis

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