In Vitro Superiority of Dual-Chambered Peritoneal Dialysis Solution with Possible Clinical Benefits

Abstract

should reflect this fact.Their design should consider the real use of PDFs.Conventional PDFs are known to disturb perito-neal membrane cell function not only as a consequenceof their acidic pH in combination with their high lac-tate concentration, but also as a result of their highconcentrations of glucose and glucose degradationproducts (GDPs), which lead to the formation of ad-vanced glycation end-products (AGEs) in the perito-neal membrane.New PD solutions are produced in dual-chamberedbags. Application of a dual-chambered continuousambulatory peritoneal dialysis (CAPD) system leadsto decreased GDP formation during heat sterilizationof glucose owing to a low pH (2.8 – 3.2) in the glu-cose-containing chamber. Thus it may be concludedthat dual-chambered PDFs, as compared with con-ventional acidic lactate-buffered PDFs, display a re-duced protein glycation potential. In addition, themixing of the two fluids before use results in a morephysiologic solution with a neutral pH, which alsocontributes to the improved biocompatibility and clini-cal comfort of these new PDFs.This review describes cell studies of acute andchronic exposure to GDPs, as well as