In summary, conventional CAPD fluids may interfere with most pathways of the intraperitoneal network of cytokines (Figure 4), potentially resulting in an impairment of important host defense functions. Thus alternative approaches are needed in order to improve dialysis fluid biocompatibility. Initial results indicate that pH neutralization and a restriction to moderate osmolality might constitute important determinants of modern dialysis fluid technology; however, clinical studies will have to prove that these fluids indeed improve the clinical outcome of the patients on long-term CAPD therapy.

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