Peritoneal Dialysis Solutions



>PD has traditionally been performed with acidic solutions containing glucose as osmotic and lactate as buffer agent. These solutions confer marked local and systemic toxicity (Fig. 12.1). Within few years, the peritoneal membrane undergoes profound morphological transformations including progressive mesothelial denudation, submesothelial fibrosis, hyaline vasculopathy, and neoangiogenesis [1]. Hypervascularization of the peritoneal membrane results in increased solute clearance, but also in rapid glucose uptake and thus ultrafiltration loss and eventually PD failure [2]. Peritonitis episodes, chronic inflammation, and a persistently elevated calcium* phosphate product further accelerate membrane transformation, which in severe cases results in life-threatening, encapsulating peritoneal sclerosis. Even though most patients will not develop these complications if early transplantation is available, they still represent a major clinical problem on a global scale as reflected by the limited long-term technique and patient survival [3].


Peritoneal dialysis solution Fluid composition biocompatible PD 


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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of General PediatricsCenter for Pediatric and Adolescent Medicine, Pediatric Nephrology DivisionHeidelbergGermany

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