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Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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Peritoneal dialysis: from bench to bedside.

Raymond T Krediet1

  • 1Department of Medicine , Academic Medical Centre , University of Amsterdam , Amsterdam , The Netherlands.

Clinical Kidney Journal
|June 30, 2015
PubMed
Summary

Peritoneal dialysis research advanced with fluid transport discoveries, identifying aquaporin-1 (AQP-1) as crucial. However, biocompatibility research has lagged, with industry solutions not fully addressing clinical needs in end-stage renal disease.

Keywords:
aquaporin-1biocompatibilityclinical/in vitro studiesfree water transportperitoneal fluid transport

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Area of Science:

  • Nephrology
  • Physiology
  • Biochemistry

Background:

  • Peritoneal dialysis has been used since the 1940s for acute renal failure and since the 1960s for end-stage renal disease.
  • The advent of continuous ambulatory peritoneal dialysis in the late 1970s significantly boosted research in the field.

Purpose of the Study:

  • To review the interplay between clinical and basic science research in peritoneal dialysis.
  • To highlight successful collaborations and areas where basic science has not effectively translated to clinical practice.

Main Methods:

  • Review of historical and current research in peritoneal dialysis, focusing on fluid transport and biocompatibility.
  • Analysis of the translation of basic science findings (e.g., aquaporin-1) to clinical applications.
  • Evaluation of research on dialysis solutions and their clinical impact.

Main Results:

  • Successful integration of physiological findings on fluid and solute transport, leading to the identification of aquaporin-1 (AQP-1) and its role in water transport during peritoneal dialysis.
  • Development of treatments targeting AQP-1 impairment.
  • Limited success in biocompatibility research, with a focus on factors not always relevant to patients and neglect of high glucose concentration effects.

Conclusions:

  • Cross-fertilization between clinical and basic science has yielded significant advancements in understanding peritoneal dialysis fluid transport.
  • Biocompatibility research requires better alignment with clinical needs to develop truly effective dialysis solutions for end-stage renal disease patients.