Biocompatible Solutions for Peritoneal Dialysis

In 1978, a simplified technique for peritoneal dialysis (PD) using plastic bags and glucose as osmotic agent allowed PD to become accepted as a home-based renal replacement therapy. However, PD was marred by complications including peritonitis and loss of function of the peritoneal membrane. Both complications may be favored by the bioincompatibility of PD solutions. The composition of PD solutions has evolved over the years, building on a better understanding of the biocompatibility and of technical advances that enable the commercial viability of certain solutions. The main osmotic agent used to obtain ultrafiltration is glucose. Conventional glucose-containing PD solutions are lactate-buffered, acidic pH solutions presented in single chambered bags. The use of new manufacturing techniques, buffer presentation, and new osmotic alternatives to glucose have resulted in more biocompatible glucose containing PD solutions that have a lower concentration of glucose degradation products (GDP) and a neutral, more physiological pH, as well as in glucose-free solutions.