Chapter 47

Solutions

Htay Htay

Htay Htay

Department of Renal Medicine, Singapore General Hospital, Singapore

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David W. Johnson

David W. Johnson

Department of Nephrology, University of Queensland at Princess Alexandra Hospital, Woolloongabba, Brisbane, Australia

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Giovanni F.M. Strippoli

Giovanni F.M. Strippoli

Department of Emergency and Organ Transplantation University of Bari, Bari, Italy

School of Public Health University of Sydney, Sydney, NSW, Australia

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Jonathan C. Craig

Jonathan C. Craig

College of Medicine and Public Health Flinders University, Adelaide, Australia

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Yeoungjee Cho

Yeoungjee Cho

Department of Nephrology, University of Queensland at Princess Alexandra Hospital, Woolloongabba, Brisbane, Australia

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First published: 18 November 2022

Summary

Peritoneal dialysis (PD) is a well-established form of kidney replacement therapy, with possible early survival advantage as compared to hemodialysis. This chapter summarizes the published studies available for neutral pH, low glucose degradation product solution, icodextrin, or amino acid-based solutions in the treatment of peritoneal dialysis and provides recommendations for the nephrologist treating patients on peritoneal dialysis. Most available studies on biocompatible solutions have been too small with too short a follow-up duration to have adequate statistical power to examine hard clinical outcomes, including technique failure and mortality. Peritonitis is one of the most common reasons for patients discontinuing PD therapy. Inflow pain can significantly affect the quality of life of patients on peritoneal dialysis. Icodextrin may slightly increase the risk of rash. Based on the available data, it is uncertain whether once-daily amino acid solution improves nutritional indices in malnourished patients.

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