Use of new peritoneal dialysis solutions in children.

A. Canepa, E. Verrina, F. Perfumo

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Standard peritoneal dialysis (PD) solutions with low pH and containing high concentrations of lactate and glucose have been demonstrated to negatively affect the peritoneal membrane, mesothelial cell viability, residential peritoneal cells, and also to inhibit phagocytic functions. An increasing body of experimental evidence supports the idea that the peritoneal hypervascularization and fibrosis observed in long-term PD are causally related to the acute and chronic toxicity of conventional PD solutions. A Physioneal (lactate/bicarbonate mixed buffer pH 7-7.4), Physioneal, Extraneal (7.5% icodextrin), Nutrineal (1.1% amino-acid-containing solution) regimen, for example, offers a significant reduction in carbohydrate load (approximately 40-50%), lower exposure to and absorption of glucose degradation products, reduced oxidative stress, and improved volume control when compared with a first-generation DDDD (4 x Dianeal) regimen. The positive aspects of each solution that we have observed in our patients allow a recommendation on the potential benefit of using these solutions in children treated with PD. In fact, data from the literature as well as the results of the studies reported in this paper show that in children the application of neutral pH bicarbonate/lactate-buffered solution for the standard nighttime APD prescription, icodextrin solution for a long daytime dwell, and AA-based solution in malnourished patients is safe and effective. Extended clinical trials should be encouraged to better define the PD schedules for the combined use of these solutions that may be associated with the best clinical efficacy and the highest level of biocompatibility.

Original languageEnglish
JournalKidney international. Supplement
Issue number108
Publication statusPublished - Apr 2008

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Dialysis Solutions
Peritoneal Dialysis
Lactic Acid
pamidronate
Bicarbonates
Peritoneal Fibrosis
Glucose
Prescriptions
Cell Survival
Appointments and Schedules
Buffers
Oxidative Stress
Carbohydrates
Clinical Trials
Amino Acids
Membranes
icodextrin

ASJC Scopus subject areas

  • Nephrology

Cite this

Use of new peritoneal dialysis solutions in children. / Canepa, A.; Verrina, E.; Perfumo, F.

In: Kidney international. Supplement, No. 108, 04.2008.

Research output: Contribution to journalArticle

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