Studying the effects of new peritoneal dialysis solutions on the peritoneum.

Studying the effects of new peritoneal dialysis solutions on the peritoneum. Research Abstract Details 

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Studying the effects of new peritoneal dialysis solutions on the peritoneum. Abstract Text:

Tak Mao Chan,Susan Yung,Tak Mao Chan,Susan Yung,

BACKGROUND: Compelling data underscore the bioincompatible nature of glucose-based peritoneal dialysis (PD) solutions and their detrimental effects on peritoneal physiology and morphology. New PD solutions have been formulated to tackle common clinical problems such as inadequate ultrafiltration or malnutrition, and to improve biocompatibility-the latter aimed at preserving the structural and functional integrity of the peritoneum and reducing adverse systemic effects on the patient. METHODS: This article reviews the factors in PD fluids that alter normal peritoneal anatomy and physiology, and the data that illustrate approaches to investigating the local and systemic biocompatibility of new PD solutions. RESULTS: Chronic exposure of the peritoneal membrane to glucose-based PD solutions results in denudation of the mesothelium, thickened submesothelium, and hyalinization of the vasculature, often resulting in reduced or lost solute and water clearance. Data from in vitro or animal experiments and clinical studies have shown improved biocompatibility profiles with new PD solutions that are glucose-free (that is, dialysates with amino acids or icodextrin), bicarbonate-buffered, or compartmentalized during heat sterilization to reduce levels of glucose degradation products. Improved biocompatibility is denoted by reduced induction of proinflammatory, profibrotic, or angiogenic growth factors in mesothelial cells and macrophages, or by less perturbation of leukocyte phagocytic function. CONCLUSIONS: Data from in vitro and animal experiments show more favorable biocompatibility profiles with new PD fluids than with glucose-based dialysates. Clinical studies are ongoing to assess the impact of the new PD fluids on peritoneal function, morbidity, and mortality.

Studying the effects of new peritoneal dialysis solutions on the peritoneum. Publishing Authors By Initials

TM Chan,S Yung,TM Chan,S Yung,

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Studying the effects of new peritoneal dialysis solutions on the peritoneum. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Peritoneal dialysis international : journal of the

VOLUME: 27 Suppl 2

Page Numbers: S87-93

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ISSN: 0896-8608

DAY: 8

MONTH: Jun

YEAR: 2007

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LANGUAGE: eng

NlmUniqueID: 8904033

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Grant and Affiliation Information for Studying the effects of new peritoneal dialysis solutions on the peritoneum.

AFFILIATION: Department of Medicine, University of Hong Kong, Hong Kong SAR, PR China. dtmchan@hkucc.hku.hk

Country: Canada

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MEDLINETA: Perit Dial Int

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