Peritoneal Dialysis - State-of-the-Art 2012

Editor(s): Ronco C. (Vicenza) 
Rosner M.H. (Charlottesville, Va.) 
Crepaldi C. (Vicenza) 
To view the fulltext, log-in or choose pay-per-view options:
Get Access

Are Current Peritoneal Dialysis Solutions Adequate for Pediatric Use?

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


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.


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.

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