Biocompatible Solutions and Long-Term Changes in Peritoneal Solute Transport

Area of Science:

• Nephrology
• Biomaterials Science
• Clinical Medicine

Background:

• Long-term peritoneal dialysis can increase peritoneal solute transport rate, linked to adverse outcomes like mortality and encapsulating peritoneal sclerosis.
• Biocompatible solutions were developed to reduce these negative effects.

Purpose of the Study:

• To investigate the association between biocompatible solutions and the longitudinal peritoneal solute transport rate in patients undergoing peritoneal dialysis.

Main Methods:

• Analysis of 366 patients from the Global Fluid Study with longitudinal peritoneal solute transport rate measurements.
• Utilized a multilevel model to assess the impact of biocompatible solutions on peritoneal solute transport rate over time, adjusting for various clinical factors.
• Compared outcomes between patients using biocompatible solutions and standard solutions over extended follow-up periods.

Main Results:

• Patients using biocompatible solutions had a lower adjusted dialysate-to-plasma creatinine ratio (0.67 vs 0.72, P=0.02) compared to standard solutions.
• Peritoneal solute transport rate plateaued after two years with biocompatible solutions, unlike the continuous increase seen with standard solutions.
• Peritonitis episodes did not increase peritoneal solute transport rate in patients using biocompatible solutions, but did in those using standard solutions.

Conclusions:

• The type of peritoneal dialysis solution influences the temporal pattern of peritoneal solute transport rate changes.
• Biocompatible solutions appear to prevent the increase in solute transport associated with peritonitis during peritoneal dialysis.