Use of pure bicarbonate-buffered peritoneal dialysis fluid reduces the incidence of CAPD peritonitis

Abstract

Our results suggest that the pure bicarbonate-buffered peritoneal dialysis fluid appears to reduce the frequency of peritonitis in CAPD patients possibly in relation to greater biocompatibility and maintenance of peritoneal membrane structural integrity. Similar results can probably relate to all low-GDP solutions.

Effects of Biocompatible versus Standard Fluid on Peritoneal Dialysis Outcomes

“…24,29,30 In this investigation, biocompatible (Balance) solution was associated with an important reduction in peritonitis risk. Similar findings have been reported in 3-year 31 and 5-year 32 nonrandomized studies of biocompatible fluid. In contrast, previous small, single-center randomized controlled trials 8,[12][13][14][15][16][17][18][19] have not shown significant differences in peritonitis rates, possibly due to insufficient statistical power, short follow-up durations, low peritonitis rates, Neyman bias, and drop-outs due to anuria.…”

The Effects of Biocompatible Compared with Standard Peritoneal Dialysis Solutions on Peritonitis Microbiology, Treatment, and Outcomes: The Balanz Trial

“…Using negative binomial regression to adjust for age, sex, nasal staphylococcal carriage, cause of end-stage renal failure, weekly Kt/V, and a 3-point subjective nursing assessment of the patients' PD skills and ability, biocompatible fluid use was associated with a significant reduction in the risk of peritonitis (adjusted odds ratio: 0.64; 95% CI: 0.43 to 0.98) (33). Similar findings were observed when the results were expressed as patient-exchanges (0.30 vs 0.50 peritonitis episodes per 1000 patient-exchanges; adjusted odds ratio: 0.65; 95% CI: 0.43 to 0.98).…”

ISPD Position Statement on Reducing the Risks of Peritoneal Dialysis–Related Infections

“…Duranay et al compared peritonitis rates for 147 patients treated with glucose, icodextrin, and amino-acid-based solutions and concluded that the type of PD solution does not appear to be a risk factor for development of peritonitis (136). Montenegro et al studied 100 incident PD patients treated with either lactate-or pure bicarbonatebuffered solutions (137) and found peritonitis rates 624 PIRAINO et al NovEMBER 2011 -voL. 31, No.…”