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Is the peritoneal dialysis biocompatibility hypothesis dead?
1Division of Nephrology, Western University and London Health Sciences Centre, London, Ontario, Canada.
Kidney International
|July 23, 2018
Summary
The peritoneal dialysis (PD) biocompatibility hypothesis suggests PD solutions damage the peritoneal membrane. A large European pediatric study found morphological evidence supporting this, challenging previous functional trial results.
Area of Science:
- Nephrology
- Biomaterials Science
- Histopathology
Background:
- The peritoneal dialysis (PD) biocompatibility hypothesis posits that conventional PD solutions, characterized by high glucose degradation products (GDPs), glucose, lactate, and low pH, induce morphological and functional damage to the peritoneal membrane.
- It is hypothesized that the use of biocompatible PD solutions could mitigate this damage.
Purpose of the Study:
- To investigate the morphological impact of conventional PD solutions on the peritoneal membrane in pediatric patients.
- To provide a morphologic correlate for the PD biocompatibility hypothesis.
Main Methods:
- Analysis of peritoneal biopsy data from a large European pediatric study.
- Evaluation of morphological changes in the peritoneal membrane.
Main Results:
- New data from a large European pediatric peritoneal biopsy study provide a morphologic correlate supporting the PD biocompatibility hypothesis.
- Findings contrast with previous randomized trials that did not support the hypothesis based on functional data.
Conclusions:
- The study provides morphological evidence supporting the hypothesis that conventional PD solutions may damage the peritoneal membrane.
- These findings have significant implications for the development and use of biocompatible PD solutions.
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