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Clinical |
Nephrology and Gastroenterology,1 SLK-Kliniken Heilbronn, Bad Friedrichshall; Department of Nephrology,2 University Hospital Heidelberg, Heidelberg, Germany
Correspondence to: J.D. Furkert, Nephrology and Gastroenterology, SLK-Kliniken Heilbronn, Am Plattenwald 1, Bad Friedrichshall, 74177, Germany. juergen.furkert{at}slk-kliniken.de
Background: Peritoneal dialysis (PD) solutions
sterilized at a low pH level contain only minimal amounts of glucose
degradation products (GDPs). The latter are known to have an adverse effect on
the peritoneal membrane. The present study retrospectively analyzes the
effects on the incidences of peritonitis and exit-site infections.
Materials and Methods: Data concerning the frequency of
peritonitis and exit-site infections for 120 patients treated with PD were
collected. Before 2000, 67 of these patients received conventional dialysates
and from 2000 on, 53 patients were treated with the new dialysis fluids.
Furthermore, a correlation between the incidence of infections and the
duration of treatment with dialysis was established.
Results: It was observed that the use of dialysis
solutions low in GDPs resulted in significantly lower rates of peritonitis
(p = 0.002) and exit-site infections (p = 0.02). When using
the new treatment, peritonitis occurred, on average, after 48 months of
treatment and exit-site infections after 34 months of treatment.
Discussion: The result supports the hypothesis that the
use of the new, biocompatible, PD solutions contributes to considerable
reduction in the rates of peritonitis and exit-site infections. As it is not
expected that randomized prospective studies will be conducted in the future,
further observational studies should be carried out in order to affirm the
observed tendencies.
KEY WORDS: Peritonitis; exit-site infections; dialysis solutions.
Received 11 December 2007; accepted 25 May 2008.
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