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

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Article / Publication Details

First-Page Preview
Abstract of Peritoneal Dialysis Solutions

Published online: 5/25/2012
Cover Date: 2012

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 0

ISBN: 978-3-318-02162-2 (Print)
eISBN: 978-3-318-02163-9 (Online)

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.


Article / Publication Details

First-Page Preview
Abstract of Peritoneal Dialysis Solutions

Published online: 5/25/2012
Cover Date: 2012

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 0

ISBN: 978-3-318-02162-2 (Print)
eISBN: 978-3-318-02163-9 (Online)


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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.
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