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New peritoneal dialysis fluids: practical use for children

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Abstract.

In recent years several new peritoneal dialysis solutions have come onto the market. These solutions differ from the conventional ones with respect to osmotic agent, buffer, and/or calcium concentration. Icodextrin-containing solutions are characterized by slow, but sustained ultrafiltration. Experience in both adults and children has been favorable for the long dwell period, giving rise to both increased ultrafiltration and clearances. The use of icodextrin during the daytime seems ideal in patients on nightly intermittent peritoneal dialysis with a low peritoneal ultrafiltration rate. However, long-term experience still has to be obtained, particularly in children. The application of pH-neutral solutions, containing bicarbonate, lactate, or a bicarbonate/lactate mixture as a buffer, has shown better preservation of peritoneal cells and better tolerance. The standard calcium concentration of 1.75 mmol/l of the dialysis solution is too high in many situations. Individual strategies for an adequate calcium balance are required depending on age, clinical situation, and oral intake of calcium and vitamin D metabolites.

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Authors and Affiliations

  1. Department of Pediatric Nephrology and Dialysis, University Hospital Utrecht/Wilhelmina Children's Hospital, PO Box 85090, 3508 AB Utrecht, The Netherlands

    Cornelis H. Schröder

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  1. Cornelis H. Schröder
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Correspondence to Cornelis H. Schröder.

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Schröder, C.H. New peritoneal dialysis fluids: practical use for children. Pediatr Nephrol 18, 1085–1088 (2003). https://doi.org/10.1007/s00467-003-1307-x

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  • DOI: https://doi.org/10.1007/s00467-003-1307-x

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