A Comparison of Biocompatible Balance Solution and Standard Peritoneal Dialysis Solution in a Single Center of Central Taiwan: A Pilot Study

Abstract

BACKGROUND: The possibility that the bioincompatible nature of standard peritoneal dialysis (PD) fluid (SPDF) might interfere with peritoneal integrity remains a concern. We conducted this study to compare Balance, a neutral pH dialysate containing low concentration of glucose degradation products (GDPs), with SPDF in patients starting on PD.METHODS: In this prospective pilot clinical study with a crossover design, seven patients starting on PD were treated with SPDF for 4 weeks and then switched to Balance for the following 12 weeks. Overnight effluent was collected and assayed for cancer antigen 125 (CA-125) and hyaluronic acid (HA). Serum samples were assayed for interleukin-6 (IL-6) and s-2 microglobulin (s2M).RESULTS: In patients treated with Balance solution, there were higher effluent levels of CA-125 (P ＜ 0.0001) and lower levels of HA (P ＜ 0.0001) under the generalized estimating equation model, while the proinflammatory cytokine IL-6 (P = 0.022) and s2M (P = 0.018) levels declined significantly. Balance had better biomarkers in PD effluuent and serum than SPDF did.CONCLUSION: We have demonstrated that the neutral pH solution Balance with low concentration of GDPs reduced significantly the proinflammatory cytokines in serum and improved the effluent markers of peritoneal membrane integrity, thus it may be able to improve the homeostasis of the peritoneal cavity. Further long-term, multicenter, randomized controlled studies are needed to elucidate the superiority of the biocompatible Balance solution compared with conventional PD solutions.