Use of glycosaminoglycans to increase efficiency of long-term continuous peritoneal dialysis

Long-term continuous ambulatory peritoneal dialysis (CAPD) frequently induces progressive structural changes in the peritoneal membrane, leading to dialysis failure. Because heparin and glycosaminoglycans favourably remodel anatomical barriers exposed to injury, we studied the effect of intraperitoneal administration of glycosaminoglycans on peritoneal dialysis efficiency. 16 CAPD patients received glycosaminoglycans for 30 days followed by a 30-day wash-out. Glycosaminoglycans in urea and creatinine dialysate-to-plasma ratios significantly increased (means 0·86 and 0·78 at baseline, 0·92 and 0·82 at 30 days, respectively). Peritoneal protein loss was reduced, and serum albumin concentration increased. We now need to assess whether glycosaminoglycans can postpone dialysis failure in the long term.