Peritoneal dialysis and inflammation

• Published in: Clinica chimica acta Vol. 430; pp. 109 - 114
• Main Authors: Velloso, Marina Souza Silva, Otoni, Alba, de Paula Sabino, Adriano, de Castro, Whocely Victor, Pinto, Sérgio Wyton Lima, Marinho, Maria Aparecida Silva, Rios, Danyelle Romana Alves
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 20-03-2014
• Subjects: Dialysis Solutions - adverse effects; Dialysis Solutions - chemistry; Glucans - adverse effects; Glucose - adverse effects; Glucose - metabolism; Humans; Hydrogen-Ion Concentration; Inflammation; Inflammation - chemically induced; Inflammation - etiology; Inflammation - pathology; Kidney Diseases - complications; Kidney Diseases - therapy; Peritoneal dialysis; Peritoneal Dialysis - adverse effects; Peritoneal dialysis solutions; Peritoneum - drug effects; Peritoneum - pathology; Taurine - adverse effects; Ultrafiltration; Peritoneal dialysis solutions; Inflammation; Peritoneal dialysis
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/j.cca.2013.12.003

Peritoneal dialysis (PD) is a kidney replacement therapy for end stage renal disease (ESRD) patients. Despite being a lifesaving treatment, the rate of mortality in patients under PD is elevated, mainly due to the chronic peritoneal dysfunction which is characterized by inflammation, peritoneal fibrosis and neoangiogenesis. The inflammatory process is trigged and modulated by the type of the peritoneal dialysis solutions (PDSs) used during PD. Currently, different PDSs are commercially available: (i) the conventional solutions; (ii) solutions of neutral pH containing low concentration of glucose degradation products (GDPs); (iii) solutions with icodextrin; and (iv) solutions containing taurine. Therefore, the aim of this review is to describe the different types of peritoneal dialysis solutions used during PD and their relationship with systemic and intraperitoneal inflammation. Some studies suggested that solutions of neutral pH containing low concentration of GDPs, icodextrin and taurine have better biocompatibility and lower influence on the inflammatory process compared to the conventional one. On the other hand, the studies, in general, were performed with a small population and for a short period of time. Therefore, further well-designed and -controlled clinical trials with larger number of individuals are required in order to better understand the role of different peritoneal dialysis solution types in the development of inflammation in patients with chronic peritoneal dialysis.
Accordingly, studies that are more well-designed, well-controlled and with a larger number of patients are needed to explain and define the role of different types of PDS in the inflammation development in patients with chronic peritoneal dialysis.
•Peritoneal dialysis (PD) is a renal replacement therapy.•PD has long-term complications: inflammation, neoangiogenesis and fibrosis.•Inflammation is trigged by the type of the peritoneal dialysis solutions.•Inflamed peritoneum leads to ultrafiltration (UF) failure.•Some PD solutions have better biocompatibility and lower influence on inflammation.