Making peritoneal dialysis a valid treatment option

Abstract

Since its introduction in late 1970s, peritoneal dialysis (PD) has been a simple, economical, and effective way to manage patients with established kidney disease. Over the last 30 years, there have been many important innovations. The first was the Y-set, a device which helps to flush the tubes before infusing dialysate into the patient—instrumental in reducing the incidence of peritonitis. Another, the PD cycler machine, which performs exchanges automatically at the patient's home, usually while the patient sleeps. And more recently, biocompatible PD solutions: Icodextrin is probably the most widely used as it increases convective transport and clearance of small solutes. It is particularly useful for the long automated PD dwell after night time. Another new type of solution comes two in compartments: one containing glucose and electrolytes and the other bicarbonate or a bicarbonate-lactate mixture. These components are mixed immediately before use, so that the final pH is close to physiological normal and thus potentially less damaging to the peritoneum over the long term.