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Perit Dial Int 29(Supplement_2): 195-197
2009
© 2009 International Society for Peritoneal Dialysis
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Part 7: Protection of Peritoneal Membrane

KARL D. NOLPH STATE OF THE ART LECTURE: FEASIBLE AND FUTURE OPTIONS FOR SALVATION OF THE PERITONEAL MEMBRANE

Raymond T. Krediet1, Annemieke M. Coester1, Inna Kolesnyk1, Marijke de Graaff1, Machteld M. Zweers1, Watske Smit1,2 and Dirk G. Struijk1,2

Division of Nephrology,1 Department of Medicine, Academic Medical Center, University of Amsterdam, and Dianet Foundation,2 Utrecht–Amsterdam, Amsterdam, Netherlands

Correspondence to: R.T. Krediet, Room F4-215, Academic Medical Center, Division of Nephrology, Department of Medicine, PO Box 22700, Amsterdam 1100 DE Netherlands. C.N.deboer{at}amc.uva.nl

A review is given of the various available strategies that can be used to protect the peritoneal membrane. A discussion of experimental studies on approaches that are still experimental, but that might be applied in patients in the future, follows. The currently available approaches include dietary sodium restriction, use of high-dose loop diuretics and of inhibitors of the renin–angiotensin system. All should preferably be combined with a dialysis prescription aimed at reducing the patient's exposure to glucose and its degradation products. 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.

KEY WORDS: Biocompatibility; ACE inhibitors; osmotic agents.






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