Peritonealdialyse gestern und heute: welche Entwicklungen und Erkenntnisse waren in den letzten Jahrzehnten bedeutend?

摘要: During the past years new developments in peritoneal dialysis (PD) technique have resulted continuous improvement of patient outcome. The importance salt and fluid balance, residual renal function glucose load are increasing interest, whereas small solute clearances lost importance. In patients with high transport rates automated PD (APD) is indicated. However, APD can also be chosen as initial treatment since recent studies show comparable or even better survival compared to ambulatory patients. Alternative solutions improve ultrafiltration (icodextrin), reduce (amino acid solution, icodextrin) protect membrane (solutions low concentration degradation products). Infection risk reduced when using antibiotic creams, but resistances should considered. Ongoing will clarify if non-antibiotic agents, e.g. medihoney, effective preventing PD-associated infections. Due these improvements hemodialysis become equivalent treatments.