The osmo-metabolic approach: a novel and tantalizing glucose-sparing strategy in peritoneal dialysis

摘要: Peritoneal dialysis (PD) is a viable but under-prescribed treatment for uremic patients. Concerns about its use include the bio-incompatibility of PD fluids, due to their potential altering functional and anatomical integrity peritoneal membrane. Many these effects are thought be high glucose content solutions, with attendant issues products generated during heat glucose-containing solutions. Moreover, excessive intraperitoneal absorption from dialysate has many systemic metabolic effects. This article reviews efforts develop alternative solutions that obviate some side effects, through replacement part other osmolytes which at least as efficient in removing fluids glucose, less impactful on patient metabolism. In particular, we will summarize clinical studies osmotic ingredients commercially available (icodextrin amino acids) preclinical under development (taurine, polyglycerol, carnitine xylitol). addition expected benefit glucose-sparing approach, describe an 'osmo-metabolic' approach formulating novel there possibility exploiting pharmaco-metabolic properties attenuate glucose. ameliorate pre-existing co-morbidities, including insulin resistance type-2 diabetes, have prevalence population,