March 26, 2014Cochrane library
Biocompatible dialysis fluids for peritoneal dialysis
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Discussion
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Implication
Systematic review reveals that biocompatible solutions preserve residual kidney function and improve fluid removal in peritoneal dialysis patients, indicating specific clinical benefits.
Key Points
- To evaluate the benefits and harms of biocompatible peritoneal dialysis solutions compared to standard solutions in patients receiving peritoneal dialysis.
- Searched the Cochrane Kidney and Transplant Specialised Register, CENTRAL, MEDLINE, EMBASE, and clinical trial registries up to February 12, 2018.
- Identified randomized controlled trials and quasi-randomized trials in children and adults comparing neutral pH, low glucose degradation product solutions or icodextrin against standard peritoneal dialysis fluids.
- Extracted outcome data using a random-effects model to determine risk ratios and mean differences with 95% confidence intervals.
- Neutral pH, low glucose degradation product solutions improved residual renal function and urine volume preservation with high certainty.
- Icodextrin increased peritoneal ultrafiltration and mitigated uncontrolled fluid overload with moderate certainty, although urine output differences were not statistically significant (3 studies, 69 participants: MD -88.88 mL/d, 95% CI -356.88 to 179.12).
- Effects of biocompatible solutions and icodextrin on peritonitis, adverse events, technique survival, and overall patient mortality remain uncertain.
Cite This Study
Cho et al. (2014) studied this question.