Coupling Osmotic Efficacy with Biocompatibility in Peritoneal Dialysis: A Stiff Challenge
Recensione
Data di Pubblicazione:
2024
Abstract:
Peritoneal dialysis (PD) is a home-based efficacious modality for the replacement of renal
function in end-stage kidney failure patients, but it is still under-prescribed. A major limitation is
the durability of the dialytic technique. Continuous exposure of the peritoneum to bioincompatible
conventional glucose-based solutions is thought to be the main cause of the long-term morphofunctional peritoneal changes that eventually result in ultrafiltration failure. Poor PD solution
biocompatibility is primarily related to the high glucose content, which is not only detrimental to
the peritoneal membrane but has many potential metabolic side effects. To improve the clinical
outcome and prolong the survival of the treatment, PD-related bioincompatibility urgently needs to
be overcome. However, combining dialytic and osmotic efficacy with a satisfactory biocompatible
profile is proving to be quite difficult. New approaches targeting the composition of the PD solution
include the replacement of glucose with other osmotic agents, and the addition of cytoprotective
or osmo-metabolic compounds. Other strategies include the infusion of mesenchymal cells or the
administration of orally active agents. In the present article, we review the current evidence on efforts
to improve the biocompatible and functional performance of PD, focusing on studies performed
in vivo (animal models of PD, human subjects on PD).
Tipologia CRIS:
1.2 Recensione in rivista
Keywords:
peritoneal dialysis; peritoneum; biocompatibility; peritoneal dialysis solution; ultrafiltration;
peritoneal fibrosis; metabolism
Elenco autori:
Bonomini, Mario; Masola, Valentina; Monco Maria, Pia; Sirolli, Vittorio; DI LIBERATO, Lorenzo; Prosdocimi, Tommaso; Arduini, Arduino
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