ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO517

Prospective Follow-Up of Peritoneal Function in New PD Patients: Comparison Between a Conventional and a More Biocompatible Dialysis Solution

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Diepen, Anouk Van, Elisabeth-Tweesteden ziekenhuis, Tilburg, Netherlands
  • Krediet, Raymond T., Academic Medical Center, Amsterdam, Netherlands
Background

Preservation of peritoneal membrane function is essential for patients on long-term peritoneal dialysis (PD). Biocompatible dialysis solutions characterized by a higher pH and a lower concentration of glucose degradation products, are hypothesized to prevent or postpone the membrane alterations that result in ultrafiltration failure and consecutive morbidity and mortality. The objective of this study was to make an in vivo comparison between conventional and biocompatible solutions and the time course of peritoneal solute and fluid transport.

Methods

We analyzed prospectively collected peritoneal transport data from 251 incident patients treated between 1994 and censoring in 2016. The maximal follow-up was 5 years. 135 patients were treated with conventional and 116 with biocompatible solutions. Linear mixed models including change point analyses were performed to compare the time course of peritoneal transport between both groups. Adjustment was made for comorbidity. The interaction with peritonitis was examined

Results

67% (conventional) and 64% (biocompatible) of the patients underwent minimally 3 transport measurements during follow up. Follow-up during the first years was characterized by consistently faster solute transport and lower ultrafiltration in the biocompatible group. After a change point at 3 years in the conventional group an increase in small solute transport occurred in these patients group (p=0.01). Thereafter solute transport increased progressively in the conventional compared to the biocompatible group. This was accompanied by a marked decrease in net ultrafiltration, which became lower in the conventional group between 3 and 4 years. Patients with a previous peritonitis in the conventional dialysis group, showed a significant decrease of transcapillary ultrafiltration already after 2 years on PD (p=0.02) while this was not present in the biocompatible dialysis group or in patients without peritonitis. The decrease in ultrafiltration was caused by both reduced free water transport (p=0.08) and small pore fluid transport (p=0.06).

Conclusion

this study emphasizes the detrimental relationship between conventional dialysis solutions, peritonitis and the acceleration of peritoneal transport abnormalities in long-term PD patients.