Protecting the peritoneal membrane: factors beyond peritoneal dialysis solutions
| Autor: | Raymond Vanholder, Nic Veys, Wim Van Biesen, Anneleen Pletinck |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Biocompatible Materials Peritonitis Risk Assessment Peritoneal dialysis Dialysis Solutions Humans Medicine In patient Intensive care medicine Uremia Potential impact business.industry Peritoneal dialysis fluid Peritoneal membrane Biocompatible material Primary Prevention Clinical Practice Bicarbonates Treatment Outcome Nephrology Kidney Failure Chronic Female Peritoneum Peritoneal dialysis solutions business Peritoneal Dialysis Follow-Up Studies |
| Zdroj: | Nature Reviews Nephrology. 8:542-550 |
| ISSN: | 1759-507X 1759-5061 |
| DOI: | 10.1038/nrneph.2012.144 |
| Popis: | Functional deterioration of the peritoneal membrane in patients on peritoneal dialysis has been described as being the result of a combination of neoangiogenesis and fibrosis. Glucose, glucose degradation products, and the unphysiological pH of the dialysate solution contribute to these changes. Although newer solutions clearly perform better in terms of their biocompatibility in an in vitro setting and in animal models, the benefit of such solutions over older solutions in the clinical setting is so far unproven. The difficulties in showing a benefit of the newer, more biocompatible solutions in the clinical setting can be explained by the fact that other factors also affect the properties of the peritoneal membrane. These factors are often neglected in clinical studies, which results in unnoticed differences in case-mix and blurs the potential impact of the novel solutions. However, many of these factors are modifiable, and attention should be paid to them in clinical practice to maintain the integrity of the peritoneal membrane. This Review focuses on factors that potentially influence the integrity of the peritoneal membrane, other than those associated with the peritoneal dialysis fluid itself. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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