dialysis solutions


Summary: Solutions prepared for exchange across a semipermeable membrane of solutes below a molecular size determined by the cutoff threshold of the membrane material.

Top Publications

  1. Davenport A, Gardner C, Delaney M. Do differences in dialysis prescription impact on KDOQI bone mineral targets? The Pan Thames Renal Audit. Blood Purif. 2010;30:111-7 pubmed publisher
  2. Wu H, Hung K, Hu F, Chen Y, Chu T, Huang J, et al. Risk factors for high dialysate glucose use in PD patients--a retrospective 5-year cohort study. Perit Dial Int. 2010;30:448-55 pubmed publisher
    ..To reduce the glucose load in chronic PD patients, alternative osmotic agents such as icodextrin or amino acids should be considered in the daily PD regimen. ..
  3. Cho Y, Badve S, Hawley C, McDonald S, Brown F, Boudville N, et al. Association of biocompatible peritoneal dialysis solutions with peritonitis risk, treatment, and outcomes. Clin J Am Soc Nephrol. 2013;8:1556-63 pubmed publisher
    ..Further randomized studies adequately powered for a primary peritonitis outcome are warranted. ..
  4. Johnson D, Brown F, Clarke M, Boudville N, Elias T, Foo M, et al. Effects of biocompatible versus standard fluid on peritoneal dialysis outcomes. J Am Soc Nephrol. 2012;23:1097-107 pubmed publisher
  5. Opatrna S, Lysak D, Trefil L, Parker C, Topley N. Intraperitoneal IL-6 signaling in incident patients treated with icodextrin and glucose bicarbonate/lactate-based peritoneal dialysis solutions. Perit Dial Int. 2012;32:37-44 pubmed publisher
    ..The utility of IL-6 level determinations, in isolation, for assessing the biocompatibility of PD solutions is questionable. ..
  6. Hecking M, Karaboyas A, Saran R, Sen A, Inaba M, Rayner H, et al. Dialysate sodium concentration and the association with interdialytic weight gain, hospitalization, and mortality. Clin J Am Soc Nephrol. 2012;7:92-100 pubmed publisher
    ..In the absence of randomized prospective studies, the benefit of reducing IDWG by decreasing DNa prescriptions should be carefully weighed against an increased risk for adverse outcomes. ..
  7. Jean G, Mayor B, Hurot J, Deléaval P, Lorriaux C, Zaoui E, et al. Biological impact of targeted dialysate calcium changes in haemodialysis patients: the key role of parathyroid hormone. Nephrol Dial Transplant. 2013;28:176-82 pubmed publisher
  8. Sirich T, Luo F, Plummer N, Hostetter T, Meyer T. Selectively increasing the clearance of protein-bound uremic solutes. Nephrol Dial Transplant. 2012;27:1574-9 pubmed publisher
    ..Selectively increasing the clearance of bound solutes provides a potential means to test their toxicity. ..
  9. Munoz Mendoza J, Bayes L, Sun S, Doss S, Schiller B. Effect of lowering dialysate sodium concentration on interdialytic weight gain and blood pressure in patients undergoing thrice-weekly in-center nocturnal hemodialysis: a quality improvement study. Am J Kidney Dis. 2011;58:956-63 pubmed publisher
    ..Prolonged exposure to higher than required dialysate sodium concentrations may drive IDWG and counteract some of the purported benefits of "go-slow" (longer session length) hemodialysis. ..

More Information


  1. Johnson D, Clarke M, Wilson V, Woods F, Brown F. Rationale and design of the balANZ trial: a randomised controlled trial of low GDP, neutral pH versus standard peritoneal dialysis solution for the preservation of residual renal function. BMC Nephrol. 2010;11:25 pubmed publisher
    ..Australian New Zealand Clinical Trials Registry Number: ACTRN12606000044527. ..
  2. Schmitt C, Borzych D, Nau B, Wühl E, Zurowska A, Schaefer F. Dialytic phosphate removal: a modifiable measure of dialysis efficacy in automated peritoneal dialysis. Perit Dial Int. 2009;29:465-71 pubmed
    ..Due to the deleterious effects of hyperphosphatemia, dialytic phosphate removal should be monitored routinely. ..
  3. Kohn O, Coe F, Ing T. Solute kinetics with short-daily home hemodialysis using slow dialysate flow rate. Hemodial Int. 2010;14:39-46 pubmed publisher
    ..Results of the present study were achieved, however, with an average of 17.5 hours of dialysis per week. ..
  4. Shah A, Davenport A. Does a reduction in dialysate sodium improve blood pressure control in haemodialysis patients?. Nephrology (Carlton). 2012;17:358-63 pubmed publisher
  5. Johnson D, Brown F, Clarke M, Boudville N, Elias T, Foo M, et al. The effects of biocompatible compared with standard peritoneal dialysis solutions on peritonitis microbiology, treatment, and outcomes: the balANZ trial. Perit Dial Int. 2012;32:497-506 pubmed
    ..Peritonitis hospitalization duration was shorter, and peritonitis severity was more commonly rated as mild in patients receiving biocompatible PD fluids, although other peritonitis outcomes were comparable between the groups. ..
  6. Hsu H, Yen C, Hsu K, Lee C, Chang S, Wu I, et al. Association between cold dialysis and cardiovascular survival in hemodialysis patients. Nephrol Dial Transplant. 2012;27:2457-64 pubmed publisher
    ..030) and cardiac mortality (P = 0.034). Our studies show that CD is significantly and independently associated with a lower risk for overall mortality and cardiac mortality. ..
  7. Santos S, Peixoto A. Sodium balance in maintenance hemodialysis. Semin Dial. 2010;23:549-55 pubmed publisher
    ..In this article, we also discuss new aspects of sodium balance, with particular attention to new observations on nonosmolar interstitial sodium storage. ..
  8. Chaudhary K, Khanna R. Biocompatible peritoneal dialysis solutions: do we have one?. Clin J Am Soc Nephrol. 2010;5:723-32 pubmed publisher
    ..This review discusses the current status of these biocompatible solutions in PD patients...
  9. LeBeouf A, Mac Way F, Utescu M, Chbinou N, Douville P, Desmeules S, et al. Effects of acute variation of dialysate calcium concentrations on arterial stiffness and aortic pressure waveform. Nephrol Dial Transplant. 2009;24:3788-94 pubmed publisher
    ..Long-term studies are necessary to evaluate the long-term effects of D(Ca) modulation on arterial stiffness. ..
  10. Perl J, Nessim S, Bargman J. The biocompatibility of neutral pH, low-GDP peritoneal dialysis solutions: benefit at bench, bedside, or both?. Kidney Int. 2011;79:814-24 pubmed publisher
  11. Gotch F, Kotanko P, Thijssen S, Levin N. The KDIGO guideline for dialysate calcium will result in an increased incidence of calcium accumulation in hemodialysis patients. Kidney Int. 2010;78:343-50 pubmed publisher
    ..The results indicate that 70% of patients on Ca-based binders and 20-50% of patients on non-Ca-based binders would require C(di)Ca(++) <2.50 mEq/l to prevent long-term Ca accumulation. ..
  12. Arramreddy R, Sun S, Munoz Mendoza J, Chertow G, Schiller B. Individualized reduction in dialysate sodium in conventional in-center hemodialysis. Hemodial Int. 2012;16:473-80 pubmed publisher
    ..65%), or intradialytic hypotension requiring an intervention (29% vs. 33%). Individualized reduction of dialysate Na(+) reduces IDWG% without significantly increasing the frequency of cramps or hypotension. ..
  13. Manlucu J, Gallo K, Heidenheim P, Lindsay R. Lowering postdialysis plasma sodium (conductivity) to increase sodium removal in volume-expanded hemodialysis patients: a pilot study using a biofeedback software system. Am J Kidney Dis. 2010;56:69-76 pubmed publisher
    ..Small number of patients. No information for dietary sodium intake. To decrease extracellular volume, it may be necessary to add diffusive to convective sodium losses. ..
  14. Jerotskaja J, Uhlin F, Fridolin I, Lauri K, Luman M, Fernström A. Optical online monitoring of uric acid removal during dialysis. Blood Purif. 2010;29:69-74 pubmed publisher
    ..The results show the possibility of estimating TR(UA) by using UV absorbance. The method appeared to be reliable also in long-term patient monitoring. ..
  15. Mc Causland F, Brunelli S, Waikar S. Dialysate sodium, serum sodium and mortality in maintenance hemodialysis. Nephrol Dial Transplant. 2012;27:1613-8 pubmed publisher
    ..Further research is warranted to determine the biological mechanisms of these associations and to re-examine total body sodium handling in hemodialysis. ..
  16. Lauri K, Tanner R, Jerotskaja J, Luman M, Fridolin I. HPLC study of uremic fluids related to optical dialysis adequacy monitoring. Int J Artif Organs. 2010;33:96-104 pubmed
  17. Johnson D, Brown F, Clarke M, Boudville N, Elias T, Foo M, et al. The effect of low glucose degradation product, neutral pH versus standard peritoneal dialysis solutions on peritoneal membrane function: the balANZ trial. Nephrol Dial Transplant. 2012;27:4445-53 pubmed publisher
    ..Adequately powered trials assessing the impact of these differential membrane effects on PD technique and patient survival rates are warranted. ..
  18. Hecking M, Karaboyas A, Saran R, Sen A, Horl W, Pisoni R, et al. Predialysis serum sodium level, dialysate sodium, and mortality in maintenance hemodialysis patients: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis. 2012;59:238-48 pubmed publisher
  19. Sands J, Kotanko P, Segal J, Ho C, Usvat L, Young A, et al. Effects of citrate acid concentrate (citrasate®) on heparin N requirements and hemodialysis adequacy: a multicenter, prospective noninferiority trial. Blood Purif. 2012;33:199-204 pubmed publisher
    ..Over 92% of P3 subjects demonstrated noninferiority of dialyzer clearance with CD and 33% HN reduction. There was no significant difference in dialyzer clotting, bleeding, or adverse events. ..
  20. Schmitt C, Bakkaloglu S, Klaus G, Schröder C, Fischbach M. Solutions for peritoneal dialysis in children: recommendations by the European Pediatric Dialysis Working Group. Pediatr Nephrol. 2011;26:1137-47 pubmed publisher
    ..Prospective comparisons of low GDP solutions with different buffer compositions are still few, and firm recommendations cannot yet be given, except when hepatic lactate metabolism is severely compromised. ..
  21. Jefferies H, Burton J, McIntyre C. Individualised dialysate temperature improves intradialytic haemodynamics and abrogates haemodialysis-induced myocardial stunning, without compromising tolerability. Blood Purif. 2011;32:63-8 pubmed publisher
    ..Individualised-temperature haemodialysis abrogates stunning, providing effective haemodynamic stabilisation at no additional therapy cost. ..
  22. Faybik P, Hetz H, Mitterer G, Krenn C, Schiefer J, Funk G, et al. Regional citrate anticoagulation in patients with liver failure supported by a molecular adsorbent recirculating system. Crit Care Med. 2011;39:273-9 pubmed publisher
  23. Kossmann R, Gonzales A, Callan R, Ahmad S. Increased efficiency of hemodialysis with citrate dialysate: a prospective controlled study. Clin J Am Soc Nephrol. 2009;4:1459-64 pubmed publisher
    ..60 +/- 0.17 versus 1.59 +/- 0.18 (P = NS), whereas in those returning to AD the eKt/Vurea decreased from 1.55 +/- 0.20 to 1.52 +/- 0.17 (P < 0.0001). Data suggest that CD use is associated with increased solute removal. ..
  24. Haag Weber M, Krämer R, Haake R, Islam M, Prischl F, Haug U, et al. Low-GDP fluid (Gambrosol trio) attenuates decline of residual renal function in PD patients: a prospective randomized study. Nephrol Dial Transplant. 2010;25:2288-96 pubmed publisher
    ..These findings suggest that GDPs might affect patient outcome related to RRF. ..
  25. Hecking M, Kainz A, Horl W, Herkner H, Sunder Plassmann G. Sodium setpoint and sodium gradient: influence on plasma sodium change and weight gain. Am J Nephrol. 2011;33:39-48 pubmed publisher
    ..IDWG correlated with the sodium gradient and more strongly with delta PNa, suggesting the need for studying other outcomes, such as morbidity and mortality. ..
  26. Witowski J, Jorres A. Effects of peritoneal dialysis solutions on the peritoneal membrane: clinical consequences. Perit Dial Int. 2005;25 Suppl 3:S31-4 pubmed
    ..This review provides an overview of recent studies that show the clinical significance of biocompatibility of peritoneal dialysis fluids. ..
  27. Yung S, Chan T. Hyaluronan--regulator and initiator of peritoneal inflammation and remodeling. Int J Artif Organs. 2007;30:477-83 pubmed
    ..This review will describe the multifaceted roles of hyaluronan in the peritoneum and how these roles are modulated during PD...
  28. Babazono T, Nakamoto H, Kasai K, Kuriyama S, Sugimoto T, Nakayama M, et al. Effects of icodextrin on glycemic and lipid profiles in diabetic patients undergoing peritoneal dialysis. Am J Nephrol. 2007;27:409-15 pubmed
    ..These hypotheses remain to be proven in controlled clinical trials. ..
  29. Thein H, Haloob I, Marshall M. Associations of a facility level decrease in dialysate sodium concentration with blood pressure and interdialytic weight gain. Nephrol Dial Transplant. 2007;22:2630-9 pubmed
    ..The lack of change in IDWG probably reflects lack of dietary salt restriction, and but does raise the issue of volume-independent effects of sodium exposure on BP. ..
  30. Smit W. Estimates of peritoneal membrane function--new insights. Nephrol Dial Transplant. 2006;21 Suppl 2:ii16-9 pubmed
    ..In this review, the new developments in monitoring peritoneal function are described and a guideline proposal for this monitoring is given. ..
  31. Pollock C. Pathogenesis of peritoneal sclerosis. Int J Artif Organs. 2005;28:90-6 pubmed
  32. De Vriese A. The John F. Maher Recipient Lecture 2004: Rage in the peritoneum. Perit Dial Int. 2005;25:8-11 pubmed
    ..The interaction of AGEs with RAGE induces peritoneal fibrosis by virtue of upregulation of TGF-beta and subsequent conversion of mesothelial cells into myofibroblasts. ..
  33. Tjiong H, Rietveld T, Wattimena J, van den Berg J, Kahriman D, van der Steen J, et al. Peritoneal dialysis with solutions containing amino acids plus glucose promotes protein synthesis during oral feeding. Clin J Am Soc Nephrol. 2007;2:74-80 pubmed
    ..The use of such a mixture may contribute to long-term improvement of the nutritional status in malnourished CAPD patients with deficient food intake. ..
  34. Szeto C, Chow K, Lam C, Leung C, Kwan B, Chung K, et al. Clinical biocompatibility of a neutral peritoneal dialysis solution with minimal glucose-degradation products--a 1-year randomized control trial. Nephrol Dial Transplant. 2007;22:552-9 pubmed
    ..It remains to be determined whether these effects could result in better long-term clinical outcome. ..
  35. Flessner M, Credit K, Henderson K, Vanpelt H, Potter R, He Z, et al. Peritoneal changes after exposure to sterile solutions by catheter. J Am Soc Nephrol. 2007;18:2294-302 pubmed
    Most current animal models that are used to study effects of long-term peritoneal exposure to dialysis solutions use an indwelling catheter for daily injections...
  36. Krediet R, Coester A, Kolesnyk I, de Graaff M, Zweers M, Smit W, et al. Karl d. Nolph state of the art lecture: feasible and future options for salvation of the peritoneal membrane. Perit Dial Int. 2009;29 Suppl 2:S195-7 pubmed
    ..The experimental studies indicate favorable effects of combining osmotic agents, together with drugs that interfere with the polyol pathway and the formation of advanced glycosylation end-products. ..
  37. Yao Q, Pawlaczyk K, Ayala E, Styszynski A, Breborowicz A, Heimburger O, et al. The role of the TGF/Smad signaling pathway in peritoneal fibrosis induced by peritoneal dialysis solutions. Nephron Exp Nephrol. 2008;109:e71-8 pubmed publisher
    ..Our findings indicate that biocompatible solutions with less glucose may decrease the rate of peritoneal fibrosis. The TGF-beta1/Smad pathway is stimulated by PD solutions, representing a plausible pathophysiological mechanism. ..
  38. Lo W, Bargman J, Burkart J, Krediet R, Pollock C, Kawanishi H, et al. Guideline on targets for solute and fluid removal in adult patients on chronic peritoneal dialysis. Perit Dial Int. 2006;26:520-2 pubmed
  39. Chan T, Yung S. Studying the effects of new peritoneal dialysis solutions on the peritoneum. Perit Dial Int. 2007;27 Suppl 2:S87-93 pubmed
    ..Clinical studies are ongoing to assess the impact of the new PD fluids on peritoneal function, morbidity, and mortality. ..
  40. Finkelstein F, Healy H, Abu Alfa A, Ahmad S, Brown F, Gehr T, et al. Superiority of icodextrin compared with 4.25% dextrose for peritoneal ultrafiltration. J Am Soc Nephrol. 2005;16:546-54 pubmed
    ..Rash was reported significantly more often in the icodextrin group. This study showed that in high-average and high transporters, icodextrin is superior to 4.25% dextrose for long-dwell fluid and solute removal. ..
  41. ter Wee P, van Ittersum F. The new peritoneal dialysis solutions: friends only, or foes in part?. Nat Clin Pract Nephrol. 2007;3:604-12 pubmed
    ..This finding could be explained by the assumption that the new peritoneal dialysis solutions not only induce less damage to the peritoneal membrane but also better maintain repair mechanisms, which ..
  42. McIntyre C. Update on peritoneal dialysis solutions. Kidney Int. 2007;71:486-90 pubmed
  43. Lee H, Choi H, Park H, Seo B, Do J, Yun S, et al. Changing prescribing practice in CAPD patients in Korea: increased utilization of low GDP solutions improves patient outcome. Nephrol Dial Transplant. 2006;21:2893-9 pubmed
    ..Reasons for the improved patient survival cannot be determined from this analysis and require further study. ..
  44. Takeguchi F, Nakayama M, Nakao T. Effects of icodextrin on insulin resistance and adipocytokine profiles in patients on peritoneal dialysis. Ther Apher Dial. 2008;12:243-9 pubmed publisher
    ..Icodextrin solution could ameliorate insulin resistance by decreasing insulin levels due to a reduction in the glucose load and an increase in plasma adiponectin levels. ..
  45. Davies S. Longitudinal relationship between solute transport and ultrafiltration capacity in peritoneal dialysis patients. Kidney Int. 2004;66:2437-45 pubmed
    ..Dialysis-induced membrane injury must involve at least two processes, for example, increased vascular surface area contact with dialysate combined with changes in hydraulic conductance due to scarring of the vessels and interstitium. ..
  46. Ricci Z, Bellomo R, Ronco C. Dose of dialysis in acute renal failure. Clin J Am Soc Nephrol. 2006;1:380-8 pubmed
  47. Westra W, Kopple J, Krediet R, Appell M, Mehrotra R. Dietary protein requirements and dialysate protein losses in chronic peritoneal dialysis patients. Perit Dial Int. 2007;27:192-5 pubmed
    ..Dialysate protein and amino acid losses constitute a small, albeit significant, proportion of total nitrogen appearance and thus may contribute to the increased dietary protein requirements of chronic PD patients. ..
  48. Marshall J, Jennings P, Scott A, Fluck R, McIntyre C. Glycemic control in diabetic CAPD patients assessed by continuous glucose monitoring system (CGMS). Kidney Int. 2003;64:1480-6 pubmed
    ..glycemic control and the effects of both nonglucose containing and more biocompatible alternative peritoneal dialysis solutions in insulin-treated continuous ambulatory peritoneal dialysis (CAPD) patients...
  49. Martikainen T, Teppo A, Gronhagen Riska C, Ekstrand A. Glucose-free dialysis solutions: inductors of inflammation or preservers of peritoneal membrane?. Perit Dial Int. 2005;25:453-60 pubmed
    Glucose and other bioincompatible factors of conventional peritoneal dialysis solutions may damage the peritoneal membrane...
  50. Mortier S, Faict D, Schalkwijk C, Lameire N, De Vriese A. Long-term exposure to new peritoneal dialysis solutions: Effects on the peritoneal membrane. Kidney Int. 2004;66:1257-65 pubmed
    ..GDPs and associated accelerated AGE formation are the main causative factors in PDF-induced peritoneal damage. ..
  51. Guth H, Gruska S, Kraatz G. On-line production of ultrapure substitution fluid reduces TNF-alpha- and IL-6 release in patients on hemodiafiltration therapy. Int J Artif Organs. 2003;26:181-7 pubmed
    ..These results indicate that not only an increase of convective mass transfer by higher volume exchange, but also a decrease in unspecific activation of immunocompetent cells may have advantages for HDF-treated patients. ..
  52. Olszowska A, Waniewski J, Werynski A, Anderstam B, Lindholm B, Wankowicz Z. Peritoneal transport in peritoneal dialysis patients using glucose-based and amino acid-based solutions. Perit Dial Int. 2007;27:544-53 pubmed
    ..continuous ambulatory peritoneal dialysis (CAPD) patients using amino acid (AA)-based versus glucose-based dialysis solutions. Using iodine-labeled human serum albumin ((125)I-HSA) as intraperitoneal volume marker, peritoneal ..
  53. Rees L. Long-term peritoneal dialysis in infants. Perit Dial Int. 2007;27 Suppl 2:S180-4 pubmed
    ..However, the long-term outcome for otherwise healthy infants is comparable to that for older children. ..