Peritoneal dialysis solutions - Differential therapy and clinical consequences [Peritonealdialyselösungen - Differenzierte therapie und klinische konsequenzen]

Conventional peritoneal dialysis (PD) solutions are bioincompatible due to their low pH, high osmolality and high glucose content, as well as their degradation products which can lead to advanced glycosylation end-product production. Alternative osmotic agents such as icodextrin and amino acid containing solutions can only be used for one exchange per day and are thus not able to fully replace glucose as the osmotic agent. Glucose solutions sterilized in multi-chambered bags are more biocompatible than standard solutions due to their very low content of glucose degradation products, and can be viewed as the new gold standard in PD treatment. Furthermore, low sodium containing PD fluids may help to reduce blood pressure and body weight in volume expanded patients and contribute to a reduction in cardiovascular morbidity and mortality. © 2007 Springer Medizin Verlag.