Re: Effects of Low-glucose Degradation Product Solution on Peritoneal Membrane Characteristics in Peritoneal Dialysis Patients: a 3-year Follow-up Study

Dear Editor, In the past issue of the Iranian Journal Kidney Disease, Park and colleagues compared the standard peritoneal dialysis (PD) solution to the low glucose degradation products (GDP) solution in a 3-year follow-up.Peritoneal dialysis (PD) is an effective and established form of renal replacement therapy in end -stage renal disease over the past 30 years, which is used by approximately 11% of the total global dialysis population. Although PD has improved the quality of life in these patients, several studies have shown inferior PD patients survival compared to hemodialysis patients. Peritonitis and physiologic dysfunction of the peritoneal membrane are major cause of peritoneal failure. Thus, a major disadvantage of this treatment is PD solution bioincompatibilty. Peritoneal dialysis solutions contain elevated concentration of glucose to provide the osmotic drive, lactate buffer to correct metabolic acidosis, and low pH to prevent glucose caramelization during heat sterilization, but heat sterilization of PD solutions can lead to glucose degradation products.