Cover

Peritoneal Dialysis - State-of-the-Art 2012

Editor(s): Ronco C. (Vicenza) 
Rosner M.H. (Charlottesville, Va.) 
Crepaldi C. (Vicenza) 
Table of Contents
Vol. 178, 2012
Section title: Peritoneal Dialysis Solutions
Ronco C, Rosner MH, Crepaldi C (eds): Peritoneal Dialysis – State-of-the-Art 2012. Contrib Nephrol. Basel, Karger, 2012, vol 178, pp 16–22
(DOI:10.1159/000337792)

Are Current Peritoneal Dialysis Solutions Adequate for Pediatric Use?

Verrina E.E. · Cannavò R. · Schaefer B. · Schmitt C.P.
aDialysis Unit, G. Gaslini Children Hospital, Genoa, Italy; bDivision of Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg, Germany

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Peritoneal dialysis (PD) is the treatment modality of choice in pediatric CKD5D patients awaiting renal transplantation. Facing many decades of renal replacement therapy long term preservation of peritoneal membrane function is of particular importance in this patient group. Whereas conventional PD fluids induce severe morphological and functional alterations of the peritoneal membrane within a few years, reduction of glucose degradation product content by multichamber systems, replacement of glucose by icodextrin and amino acids, and of lactate by bicarbonate at a neutral to physiological pH are expected to preserve peritoneal membrane integrity. Based on numerous in vitro, experimental and clinical studies, the European Pediatric Dialysis Working Group recommended the use of low glucose degradation product solutions whenever possible. Icodextrin is considered a useful option, in particular in children with sodium and water overload, even though infants may absorb higher amounts of icodextrin and achieve less ultrafiltration. The concept of amino acid-based PD fluids is intriguing, but pediatric benefits are insufficiently described and cannot replace tube feeding in malnourished children. Bicarbonate-based PD fluids better control metabolic acidosis and have been recommended in children with acute kidney injury and impaired lactate metabolism. This review discusses the scientific evidence and potential advantages of PD solutions with an improved biocompatibility profile, with a particular focus on pediatric studies.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Fischbach M, Stefanidis CJ, Watson AR: European Paediatric Peritoneal Dialysis Working Group: Guidelines by an ad hoc European committee on adequacy of the paediatric peritoneal dialysis prescription. Nephrol Dial Transplant 2002;17:380-385
  2. Williams JD, Craig KJ, Topley N, Von Ruhland C, Fallon M, Newman GR, Mackenzie RK, Williams GT: Morphologic changes in the peritoneal membrane of patients with renal disease. J Am Soc Nephrol 2002;13:470-479
  3. Yoshino A, Honda M, Fukuda M: , et al Changes in peritoneal equilibration test values during long-term peritoneal dialysis in peritonitis-free children. Perit Dial Int 2001;21:180-185
  4. Schmitt CP, Haraldsson B, Doetschmann R, Zimmering M, Greiner C, Boswald M, Klaus G, Passick-Deetjen J, Schaefer F: Effects of pH-neutral, bicarbonate-buffered dialysis fluid on peritoneal transport kinetics in children. Kidney Int 2002;61:1527-1536
  5. Schmitt CP, von Heyl D, Rieger S: , et al Reduced systemic advanced glycation endproducts in children receiving peritoneal dialysis with low glucose degradation product content. Nephrol Dial Transplant 2007;22:2038-2044
  6. Haag-Weber M, Kramer R, Islam M: , et al Low GDP fluid (Gambrosol trio R) attenuates decline of residual renal function in PD patients. Nephrol Dial Transplant 2010;25:2288-2296
  7. Müller-Krebs S, Kihm LP, Zeier B, Gross ML, Deppisch R, Wieslander A, Henle T, Penndorf I, Oh J, Reiser J, Nawroth PP, Zeier M, Schwenger V: Renal toxicity mediated by glucose degradation products in a rat model of advanced renal failure. Eur J Clin Invest 2008;38:296-305
  8. Schmitt CP, Bakkaloglu SA, Klaus G, Schroeder C, Fischbach M: Solutions for peritoneal dialysis in children: recommendations by the European Pediatric Dialysis Working Group. Pediatr Nephrol 2011;26:1137-1147
  9. Bargman JM: Slouching towards Bethlehem: the beast of biocompatibility. Nephrol Dial Transplant 2010;25:2050-2051
  10. Erixon M, Wieslander A, Lindén T, Carlsson O, Forsbäck G, Svensson E, Jönsson JA, Kjellstrand P: How to avoid glucose degradation products in peritoneal dialysis fluids. Perit Dial Int 2006;26:490-497
  11. De Boer AW, Schröder CH, Van Vliet R: , et al Clinical experience with icodextrin in children: ultrafiltration profiles and metabolism. Pediatr Nephrol 2000;15:21-24
  12. van Hoeck KJ, Rusthoven E, Vermeylen L: , et al Nutritional effects of increasing dialysis dose by adding an icodextrin daytime dwell to Nocturnal Intermittent Peritoneal Dialysis (NIPD) in children. Nephrol Dial Transplant 2003;18:1383-1387
  13. Canepa A, Verrina E, Perfumo F: Use of new peritoneal dialysis solutions in children. Kidney Int 2008;108:S137-S144
  14. Rusthoven E, van der Vlugt ME, van Lingen-van Bueren LJ: , et al Evaluation of intraperitoneal pressure and the effect of different osmotic agents on intraperitoneal pressure in children. Perit Dial Int 2005;25:352-356
  15. Dart A, Feber J, Wong H: , et al Icodextrin re-absorption varies with age in children on automated peritoneal dialysis. Pediatr Nephrol 2005;20:683-685
  16. Gotloib L, Wajsbrot V, Shostak A: Osmotic agents hamper mesothelial repopulation as seen in the doughnut in vivo model. Perit Dial Int 2005;25:(suppl 3)S26-S30
  17. Bender TO, Witowski J, Aufricht C, Endemann M, Frei U, Passlick-Deetjen J, Jorres A: Biocompatibility of a bicarbonate-buffered amino-acid based solution for peritoneal dialysis. Pediatr Nephrol 2008;23:1537-1543
  18. Canepa A, Perfumo F, Carrea A: , et al Long-term effect of amino-acid dialysis solution in children on continuous ambulatory peritoneal dialysis. Pediatr Nephrol 1991;5:215-219
  19. Canepa A, Verrina E, Perfumo F: , et al Value of intraperitoneal amino acids in children treated with chronic peritoneal dialysis. Perit Dial Int 1999;19:(suppl 2)S435-S440
  20. Le Poole CY, Welten AG, Weijmer MC, Valentijn RM, van Ittersum FJ, ter Wee PM: Initiating CAPD with a regimen low in glucose and glucose degradation products, with icodextrin and amino acids (NEPP) is safe and efficacious. Perit Dial Int 2005;25:(suppl 3)S64-S68
  21. Freida P, Galach M, Divino Filho JC, Werynski A, Lidholm B: Combination of crystalloid (glucose) and colloid (icodextrin) osmotic agents markedly enhances peritoneal fluid and solute transport during the long PD dwell. Perit Dial Int 2007;27:267-276
  22. Akonur A, Leypoldt JK: Three-pore model predictions of 24-hour automated peritoneal dialysis therapy using bimodal solutions. Perit Dial Int 2011;31:537-544
  23. Ogata S, Mori M, Tatsukawa Y, Kiribayashi K, Yorioka N: Expression of vascular endothelial growth factor, fibroblast growth factor, and lactate deydrogenase by human peritoneal mesothelial cells in solutions with lactate or bicarbonate or both. Adv Perit Dial 2006;22:37-40
  24. Yihui Zhai Y, Bloch J, Hömme M, Schaefer J, Hackert T, Philippin B, Schwenger V, Schaefer F, Schmitt CP: Buffer-dependent regulation of aquaporin-1 expression and function in human peritoneal mesothelial cells. Pediatr Nephrol 2012;Mar 1. [Epub ahead of print]
  25. Simonsen O, Sterner G, Carlsson O, Wieslander A, Rippe B: Improvement of peritoneal ultrafiltration with peritoneal dialysis solution buffered with bicarbonate/lactate mixture. Perit Dial Int 2006;26:353-359
  26. Fischbach M, Terzic J, Chauvé S, Laugel V, Muller A, Haraldsson B: Effect of peritoneal dialysis fluid composition on peritoneal area available for exchange in children. Nephrol Dial Transplant 2004;19:925-932
  27. Haas S, Schmitt CP, Arbeiter K, Bonzel KE, Fischbach M, John U, Pieper AK, Schaub TP, Passlick-Deetjen J, Mehls O, Schaefer F: Improved acidosis correction and recovery of mesothelial cell mass with neutral-pH bicarbonate dialysis solution among children undergoing automated peritoneal dialysis. J Am Soc Nephrol 2003;14:2632-2638
  28. Rajimakers R, Coester A, Smit W, Krediet RT, Schroeder CH: Free water transport in children on peritoneal dialysis is higher with more biocompatible dialysis solutions, higher with older age and declines with time. Nephrol Dial Transplant 2012;27:1183-1190
  29. Davies S, Carlsson O, Simonsen O, Johansson AC, Venturoli D, Ledebo J, Wieslander A, Chan C, Rippe B: The effects of low-sodium peritoneal dialysis fluids on blood pressure, thirst and volume status. Nephrol Dial Transplant 2009;24:1609-1617


Pay-per-View Options
Direct payment This item at the regular price: USD 33.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 23.00