Lessons From Single Cell Organisms: Insights Into the Antimicrobial and Toxic Effects of Peritoneal Dialysate Bases

Abstract

Although it was first described over a quarter of a century ago, the mechanisms behind the antimicrobial activity of fresh peritoneal dialysate have been poorly understood. Recent insight into the biochemistry appears to suggest that at least part of the effect resides in the salts of the carboxylic acids. An understanding of the metabolic pathways of both sensitive and resistant organisms has not only led to an understanding of the mechanisms of the antimicrobial effect, but also may have provided the insight for future studies to reduce toxicity to the peritoneal membrane. While our knowledge base in this area is still evolving, an improved understanding of the biochemical basis of both the antibacterial effect and toxicity of the salts of carboxylic acids in peritoneal dialysate can only prove useful.

A Taurolidine–Citrate–Heparin Lock Solution Effectively Eradicates Pathogens From the Catheter Biofilm in Hemodialysis Patients

“…16 However, one might expect a slight increase in the incidence of infections when using taurolidine-citrate-heparin in comparison with when using taurolidine-citrate alone, and no statistically significant differences were discovered. 17 Although a taurolidine-citrate-urokinase lock solution was only applied once, it seems that its value cannot be underestimated in this regard.…”