Peritoneal exposure model in the rat as a tool to unravel bio(in)compatibility of PDF

Patients treated with peritoneal dialysis (PD) are at risk for development of ultrafiltration failure and peritonitis. The relative unphysiologic composition of the currently used peritoneal dialysis fluids (PDF) is a major cause for the development of morphologic changes of the peritoneal membrane such as fibrosis and new vessel formation, ultimately resulting in ultrafiltration failure. In recent years, a major research focus has become the development of new and improved PDF. Typically, the first phase of biocompatibility testing of new PDF involves in vitro testing, using cell culture systems such as primary mesothelial cells or peritoneal macrophages. In vivo studies using animal models permit the analysis of biocompatibility under conditions that allow for cell-to-cell interactions and dynamic changes in solution composition that more closely mimic the clinical situation. In this paper, we will review the applicability of a peritoneal exposure model in the rat to study PDF biocompatibility-related issues.