Maßnahmen zum peritonealen Langzeiterhalt

ZUSAMMENFASSUNG

Die Zahl an Patienten, die auf ein Nierenersatzverfahren angewiesen sind, steigt stetig. Die Peritonealdialyse (PD) ist eine Methode zur Nierenersatztherapie, die hinsichtlich der Lebensqualität und Patientenautonomie häufig Vorteile gegenüber der Hämodialyse bieten kann. Allerdings ist die Langzeit-PD mit chronischen Veränderungen der Peritonealmembran wie Fibrose assoziiert, die den Teilchen- und Wassertransport erheblich beeinträchtigen und zum Ultrafiltrationsversagen führen können. Schlimmstenfalls treten schwere Komplikationen wie die enkapsulierende Peritonealsklerose (EPS) auf. In einigen Fällen kommt es sehr früh, d. h. nach etwa 5 Jahren oder weniger, zu Veränderungen, die zu einem Therapieversagen führen, sodass die PD beendet werden muss. Daher ist der möglichst lange Funktionserhalt der Membran von großer Bedeutung. In diesem Beitrag geben wir einen Überblick über Maßnahmen zum peritonealen Langzeiterhalt sowie einen Ausblick auf neue, potenzielle Therapeutika, die zu einer längeren Integrität der Peritonealmembran beitragen könnten.

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