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Effects of peritoneal dialysis solutions low in GDPs on peritonitis and exit-site infection rates
Jürgen Furkert1, Martin Zeier, Vedat Schwenger
1Nephrology and Gastroenterology, SLK-Kliniken Heilbronn, Bad Friedrichshall, Germany. juergen.furkert@slk-kliniken.de
Background:
Peritoneal dialysis (PD) solutions sterilized at a low pH level contain only minimal amounts of glucose degradation products (GDPs). The latter are known to have an adverse effect on the peritoneal membrane. The present study retrospectively analyzes the effects on the incidences of peritonitis and exit-site infections.
Materials And Methods:
Data concerning the frequency of peritonitis and exit-site infections for 120 patients treated with PD were collected. Before 2000, 67 of these patients received conventional dialysates and from 2000 on, 53 patients were treated with the new dialysis fluids. Furthermore, a correlation between the incidence of infections and the duration of treatment with dialysis was established.
Results:
It was observed that the use of dialysis solutions low in GDPs resulted in significantly lower rates of peritonitis (p = 0.002) and exit-site infections (p = 0.02). When using the new treatment, peritonitis occurred, on average, after 48 months of treatment and exit-site infections after 34 months of treatment.
Discussion:
The result supports the hypothesis that the use of the new, biocompatible, PD solutions contributes to considerable reduction in the rates of peritonitis and exit-site infections. As it is not expected that randomized prospective studies will be conducted in the future, further observational studies should be carried out in order to affirm the observed tendencies.
Insights
New biocompatible peritoneal dialysis (PD) solutions, low in glucose degradation products (GDPs), significantly reduce rates of peritonitis and exit-site infections in PD patients. This suggests improved patient outcomes with these advanced PD fluids.
Area of Science:
- Nephrology
- Biomaterials Science
- Clinical Medicine
Background:
- Peritoneal dialysis (PD) solutions sterilized at low pH contain minimal glucose degradation products (GDPs).
- GDPs are known to adversely affect the peritoneal membrane.
- Previous research indicates a link between GDPs and peritoneal membrane complications.
Purpose of the Study:
- To retrospectively analyze the impact of low-GDP PD solutions on peritonitis and exit-site infection rates.
- To compare infection incidences between conventional and new PD fluids.
- To establish a correlation between infection rates and PD treatment duration.
Main Methods:
- Retrospective analysis of infection data from 120 PD patients.
- Comparison of infection rates in patients using conventional dialysates (before 2000) versus new, low-GDP fluids (from 2000 onwards).
- Statistical analysis to determine the significance of observed differences and correlations.
Main Results:
- Significantly lower rates of peritonitis (p = 0.002) and exit-site infections (p = 0.02) were observed with low-GDP PD solutions.
- Peritonitis occurred after an average of 48 months with new fluids, compared to earlier occurrences with conventional fluids.
- Exit-site infections occurred after an average of 34 months with new fluids.
Conclusions:
- The use of new, biocompatible PD solutions low in GDPs contributes to a significant reduction in peritonitis and exit-site infections.
- Findings support the hypothesis that reduced GDP exposure improves PD patient outcomes.
- Further observational studies are recommended to confirm these tendencies, given the unlikelihood of future randomized prospective trials.
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