What has balANZ taught us about balancing ultrafiltration with membrane preservation?

摘要

It has been difficult to show clinically meaningful benefits of the biocompatible peritoneal dialysis solutions. The balANZ trial is the most important attempt to do this so far, showing delayed time to anuria, less frequent and severe peritonitis and in this edition of NDT differential effects on membrane function. In the short term, the biocompatible, normal pH, low glucose degradation product (GDPs) containing the fluid 'Balance' increased solute transport and reduced ultrafiltration (UF) capacity, whereas no progressive changes in membrane function were seen over two years in contrast to the conventional solution. How these short- and long-term differences interact with the preservation of residual renal function and protection of membrane function undoubtedly shed light on how we should manage patients on PD.