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Type: Journal article
Title: Effects of biocompatible versus standard fluid on peritoneal dialysis outcomes
Author: Johnson, D.
Brown, F.
Clarke, M.
Boudville, N.
Elias, T.
Foo, M.
Jones, B.
Kulkarni, H.
Langham, R.
Ranganathan, D.
Schollum, J.
Suranyi, M.
Tan, S.
Voss, D.
Citation: Journal of the American Society of Nephrology, 2012; 23(6):1097-1107
Publisher: Lippincott Williams & Wilkins
Issue Date: 2012
ISSN: 1046-6673
Statement of
David W. Johnson, Fiona G. Brown, Margaret Clarke, Neil Boudville, Tony J. Elias, Marjorie W.Y. Foo, Bernard Jones, Hemant Kulkarni, Robyn Langham, Dwarakanathan Ranganathan, John Schollum, Michael Suranyi, Seng H. Tan and David Voss on behalf of the balANZ Trial Investigators
Abstract: The clinical benefits of using "biocompatible" neutral pH solutions containing low levels of glucose degradation products for peritoneal dialysis compared with standard solutions are uncertain. In this multicenter, open-label, parallel-group, randomized controlled trial, we randomly assigned 185 incident adult peritoneal dialysis patients with residual renal function to use either biocompatible or conventional solution for 2 years. The primary outcome measure was slope of renal function decline. Secondary outcome measures comprised time to anuria, fluid volume status, peritonitis-free survival, technique survival, patient survival, and adverse events. We did not detect a statistically significant difference in the rate of decline of renal function between the two groups as measured by the slopes of GFR: -0.22 and -0.28 ml/min per 1.73 m(2) per month (P=0.17) in the first year in the biocompatible and conventional groups, respectively, and, -0.09 and -0.10 ml/min per 1.73 m(2) per month (P=0.9) in the second year. The biocompatible group exhibited significantly longer times to anuria (P=0.009) and to the first peritonitis episode (P=0.01). This group also had fewer patients develop peritonitis (30% versus 49%) and had lower rates of peritonitis (0.30 versus 0.49 episodes per year, P=0.01). In conclusion, this trial does not support a role for biocompatible fluid in slowing the rate of GFR decline, but it does suggest that biocompatible fluid may delay the onset of anuria and reduce the incidence of peritonitis compared with conventional fluid in peritoneal dialysis.
Keywords: balANZ Trial Investigators
Kidney Failure, Chronic
Biocompatible Materials
Dialysis Solutions
Kidney Function Tests
Glomerular Filtration Rate
Treatment Outcome
Peritoneal Dialysis
Severity of Illness Index
Confidence Intervals
Risk Assessment
Survival Analysis
Follow-Up Studies
Cross-Over Studies
Hydrogen-Ion Concentration
Time Factors
Reference Values
Middle Aged
Kaplan-Meier Estimate
Rights: Copyright © 2012 by the American Society of Nephrology
DOI: 10.1681/ASN.2011121201
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