Animal Models for Peritoneal Dialysis

Abstract

p eritoneal dialysis is an accepted and still growing method of replacement therapy in patients with end-stage renal failure. However, because it has some limitations and disadvantages, its future depends on innovations that will make the treatment more effective and eliminate or maximally reduce its side effects. Such improvements are especially important in uremic patients who have no residual renal function. It is also important to preserve the peritoneal membrane and to prevent the development of fibrotic changes in the peritoneum. Since the end of the 1980s, the rapid development of experimental in vitro techniques, based on a better understanding of molecular biology, has resulted in a relative decrease in the number of peritoneal dialysis studies performed on animals. With the introduction of continuous ambulatory peritoneal dialy sis (CAPD) and the prolongation of its duration up to several years, new challenges appeared, such as bioincompatibility of dialysis fluids and resulting damage to the peritoneum with subsequent loss of ultrafiltration. These complications became priorities in peritoneal dialysis research (1). Many excellent in vitro studies have determined which components of conventional dialysis fluids are responsible for bioincompatibility (2). Further re search has suggested what alterations in the composition of dialysis fluids will make them more biocompatible (3). Here, a major advance was the introduction of solutions with neutral pH and bicarbonate, or a mixture of bicarbonate and lactate as buffers. However, despite much information (derived from in vitro experiments) about the superiority of such solutions over conventional, acidic, lactate-buffered