[Biocompatible fluids for peritoneal dialysis: do they have a clinical impact?]

The bioincompatibility of conventional peritoneal dialysis fluid may be responsible for short- and long-term damage to the peritoneal membrane. New, more biocompatible fluids are now commercially available and convincing results have been obtained in surrogate markers for the viability and function of peritoneal resident cells. However, these fluids have not yet proved to have clinical effects such as better preservation of peritoneal membrane morphology and function. Several randomized studies have recently demonstrated clinically relevant systemic benefits, including improvement or preservation of the residual renal function and a decrease in serum AGE levels. In addition, a retrospective observational study has suggested better patient survival with the use of biocompatible peritoneal dialysis fluid as compared with conventional fluid. These achievements still have to be considered preliminary; however, they may eventually result in the adoption of the new fluids as the gold standard for peritoneal dialysis.