Therapeutic potential of amino acid-based peritoneal dialysis solutions: a systematic review

Lindholm, Bengt, Barbari, Antoine, Allen, Jennifer, Dufour, Inès, Fraser, Donald ORCID: https://orcid.org/0000-0003-0102-9342, Heider, Annette, Kazancioglu, Rumeyza, Lichodziejewska-Niemierko, Monika, Malho-Guedes, Anabela, Neri, Loris, Parikova, Alena, Quevedo-Reina, Juan Carlos, Santana-Quintana, Adonay and Udayaraj, Udaya 2026. Therapeutic potential of amino acid-based peritoneal dialysis solutions: a systematic review. BMC Nephrology 27 , 449. 10.1186/s12882-026-05222-3

PDF - Published Version Available under License Creative Commons Attribution. Download (1MB)

Abstract

Peritoneal dialysis (PD) offers many advantages over hemodialysis but chronic exposure to bio-incompatible glucose-based PD solutions and continuous absorption of glucose from the dialysate may lead to peritoneal membrane (PM) dysfunction and systemic metabolic complications such as hyperglycemia, insulin resistance, dyslipidemia, and obesity. Replacing one daily exchange of 1.36% glucose-based solution with one 1.1% amino acid-based PD solution may provide nutritional benefits of amino acid supplementation, improve biocompatibility, and reduce the peritoneal glucose load while maintaining similar ultrafiltration and solute removal capacity. Randomized clinical trials and mechanistic studies show beneficial effects of amino acid-based PD solutions on peritoneal homeostasis, preserved viability of the PM, and favorable nutritional and metabolic effects. This systematic review highlights the clinical rationale for implementing use of amino acid–based PD solutions as an integral part of glucose-sparing strategies in PD to reduce the cumulative intraperitoneal glucose load and mitigate its well-documented adverse effects. Amino acid–based PD solutions emerge as a clinically viable, glucose-free alternative and a nutritionally beneficial option that can improve the nutritional status of PD patients by providing essential amino acids when used as part of a comprehensive glucose-sparing strategy. Targeted use of these solutions, particularly in malnourished or high-risk patients, represents a personalized approach to optimizing peritoneal dialysis outcomes.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Schools > Medicine
Publisher:	BioMed Central
ISSN:	1471-2369
Date of First Compliant Deposit:	10 August 2026
Date of Acceptance:	17 July 2026
Last Modified:	10 Aug 2026 14:15
URI:	https://orca.cardiff.ac.uk/id/eprint/188838

Actions (repository staff only)

Edit Item