Peritoneal dialysis solutions low in glucose degradation products: clinical experience and outcomes

The latest literature describing clinical experiences with peritoneal dialysis solutions low in glucose degradation products (GDPs) is mostly consistent with previous reports suggesting less inflammation, better peritoneal mesothelial mass preservation, a lower rate of decline of residual renal function, and improved patient survival. The data suggest stable peritoneal transport rates, but no definite evidence has yet emerged of superior membrane preservation. Most studies have reported very low peritonitis rates, but without significant differences as compared with rates in patients exposed to conventional solutions. New, appropriately powered randomized clinical trials are needed to confirm the potential benefits of low-GDP solutions and to establish the role of renal function preservation with regard to those benefits.