Peritoneal damage by peritoneal dialysis solutions

Abstract

Continuous ambulatory peritoneal dialysis is a well-accepted treatment for end-stage renal disease, but its long-term success is limited. Peritoneal sclerosis is still one of the most important complications of long-term peritoneal dialysis and the low biocompatibility of peritoneal dialysis solutions plays a major role in the development of such sclerosis. In this review, we summarize recent experimental data about the biocompatibility of peritoneal dialysis solutions.

A Novel Formulation of Glucose-Sparing Peritoneal Dialysis Solutions with l-Carnitine Improves Biocompatibility on Human Mesothelial Cells

“…Damage of intercellular junctions leads to an increase in the solute permeability. High glucose concentration, along with high osmolarity, damage intercellular junctions in human peritoneal mesothelial cells [38,48]. These changes are accompanied by a reduction in the TEER and increase in paracellular transport [49].…”

Alterations of Intercellular Junctions in Peritoneal Mesothelial Cells from Patients Undergoing Dialysis: Effect of Retinoic Acid

“…Continuous ambulatory peritoneal dialysis is associated with morphologic changes of mesothelial cells, such as loss of the microvilli, widening of the intercellular spaces, and exfoliation. High glucose concentration in the culture media damage the intercellular junctions of HPMCs, with the damage not only being induced by glucose itself but also by hyperosmolality, and a glucosestimulated increase of transforming growth factor-β1 and reactive oxygen species (17,(23)(24)(25)(26). Mesothelium provides resistance against solute permeation.…”

Mizoribine Suppresses the Progression of Experimental Peritoneal Fibrosis in a Rat Model

“…However, long-term PD treatment is associated with histopathological alterations in the peritoneum [1]. Continuous exposure to bioincompatible dialysis fluids and repeated episodes of bacterial peritonitis play a major role in the alteration of peritoneal function and structure that occurs with time [2, 3]. The characteristic pathologic findings in the peritoneum of patients on long-term continuous ambulatory peritoneal dialysis (CAPD) therapy include marked peritoneal fibrosis with marked accumulation of collagen and loss of peritoneal mesothelial cells [4].…”