The peritoneal tissue in patients on peritoneal dialysis (PD) is exposed to several tons of PD fluid every year. Basically, the composition of PD fluid mimics the body’s extracellular fluid, but extra components and other concentrations are needed to remove fluid and solutes from the blood. The PD procedure by itself and the adverse effects of some fluid components could be the reason for the limited long-term survival of the peritoneal membrane as a dialyzing membrane.
Many studies have demonstrated adverse effects of PD fluids on cells from the peritoneal cavity. The most obvious incriminating characteristics are the low pH, the high lactate concentration, the high osmolality and the high glucose concentration. As if this were not enough, it has also been demonstrated that during heat sterilization and storage of PD fluids, some of the glucose is degraded to reactive substances referred to as glucose degradation products (GDPs).
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