KARL D. NOLPH STATE OF THE ART LECTURE: FEASIBLE AND FUTURE OPTIONS FOR SALVATION OF THE PERITONEAL MEMBRANE

• Published in: Peritoneal dialysis international Vol. 29; no. Supplement_2; pp. S195 - 197
• Main Authors: Krediet, Raymond T, Coester, Annemieke M, Kolesnyk, Inna, de Graaff, Marijke, Zweers, Machteld M, Smit, Watske, Struijk, Dirk G
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Milton, ON Multimed 01-02-2009
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Animals; Biological and medical sciences; Dialysis Solutions - pharmacokinetics; Dialysis Solutions - standards; Diuretics - therapeutic use; Emergency and intensive care: renal failure. Dialysis management; Glucose - pharmacokinetics; Glycation End Products, Advanced - metabolism; Humans; Intensive care medicine; Medical sciences; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Peritoneal Dialysis - standards; Peritoneal Diseases - etiology; Peritoneal Diseases - metabolism; Peritoneal Diseases - prevention & control; Peritoneum - drug effects; Peritoneum - metabolism; Practice Guidelines as Topic; Renal failure; Kidney disease; Extrarenal dialysis; State of the art; Urinary system disease; Renal failure; Biocompatibility; Review; ACE inhibitors; Peritoneal dialysis; ACE inhibitor; osmotic agents
• ISSN: 0896-8608; 1718-4304
• DOI: 10.1177/089686080902902s39

Division of Nephrology, 1 Department of Medicine,
Academic Medical Center, University of Amsterdam, and Dianet
Foundation, 2 Utrecht–Amsterdam, Amsterdam,
Netherlands
Correspondence to: R.T. Krediet, Room F4-215, Academic Medical Center,
Division of Nephrology, Department of Medicine, PO Box 22700, Amsterdam 1100
DE Netherlands.
C.N.deboer{at}amc.uva.nl
A review is given of the various available strategies that can be used
to protect the peritoneal membrane. A discussion of experimental studies on
approaches that are still experimental, but that might be applied in patients
in the future, follows. The currently available approaches include dietary
sodium restriction, use of high-dose loop diuretics and of inhibitors of the
renin–angiotensin system. All should preferably be combined with a
dialysis prescription aimed at reducing the patient's exposure to glucose and
its degradation products. The experimental studies indicate favorable effects
of combining osmotic agents, together with drugs that interfere with the
polyol pathway and the formation of advanced glycosylation
end-products.
KEY WORDS: Biocompatibility; ACE inhibitors; osmotic agents.