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Benefits

Minimize GDP-related complications

It is well known that glucose degradation products (GDPs) play a major role in the bio-incompatibility of PD fluids3. They exhibit direct toxicity and promote the formation of advanced glycation end products (AGEs). Both GDPs and AGEs have negative local and systemic effects. The use of low GDP fluids helps to avoid important clinical problems such as declining residual renal function3,4.

Minimize GDP-related complications

Lowest level of GDPs compared to other biocompatible PD fluids

PD fluids with lowest GDP levels – only from Fresenius Medical Care1

balance contains about 4.4 times less GDPs compared to Physioneal, specifically for the most bioactive and cytotoxic GDPs 3,4-DGE and 3-DG. Therefore, today, Fresenius Medical Care is the only provider of biocompatible PD fluids with the lowest level of GDPs.

Gdp Concentrations
GPD concentrations in PD fluids vary significantly.

The balANZ study shows that patients on balance experienced significantly shorter peritonitis-related hospitalization5. Moreover, approx. 70% of patients were actually peritonitis-free for 2 years5.

Less hospitalization costs

Shorter duration of peritonitis-associated hospitalization

UltraLow GDP therapy pays off from day one

GDPs exhibit adverse effects from day one3. That’s why it is so important to limit GDP exposure at the initiation of therapy.

UltraLow GDP fluids from the start help to alleviate important clinical problems, such as peritoneal membrane changes, declining peritoneal ultrafiltration and residual renal function, as well as infection6, 7, 8, 9.

For CAPD and APD therapy

Use of our UltraLow GDP fluids is not limited to a certain modality: balance is available for patients on APD as well as for patients on CAPD.

Studies

Balanz study

The balANZ study: clear advantages for your patients 5,6,10

The investigator initiated balANZ study compared important clinical outcomes of balance vs. conventional PD fluid at the highest scientific level. The published results were considered as “The most significant publications in peritoneal dialysis (PD) in 2012”11

The results of the balANZ study are so far published in three individual articles in major journals of nephrology, each article focusing on different aspects.5,6,10 A recent and comprehensive GDP analysis of PD fluids is part of the publication from Himmele et al.1

balANZ: main publication

“Effects of Biocompatible versus Standard Fluid on Peritoneal Dialysis Outcomes”10

Key results from this publication

Patients on balance showed:

  • Delayed onset of anuria: 7% vs 20% anuric patients (p = 0.009)
  • Reduced incidence of peritonitis: 30% vs 49% of patients (p = 0.01)
Read the article
balANZ: main publication

balANZ: membrane

“The effect of low glucose degradation product, neutral pH versus standard peritoneal dialysis solutions on peritoneal membrane function: the balANZ trial”6

Key results from this publication

Patients on balance showed:

  • More stable peritoneal membrane transport by D/P creatinine: (p < 0.001)
Read the article
balanz-study-outcomes_2

balANZ: infection

“The effects of biocompatible compared with standard peritoneal dialysis solutions on peritonitis microbiology, treatment, and outcomes: the balANZ trial”5

Key results from this publication

Patients on balance showed:

  • Shorter medium duration of peritonitis-associated hospitalization: 6 vs 11 days (p = 0.05)
  • Milder peritonitis severity: 37% vs 10% of episodes (p = 0.001)
  • Reduced incidence of peritonitis: 30% vs 49% of patients (p = 0.01)
Read the article
balANZ: infection

GDPs analysis

“A new neutral-pH low-GDP peritoneal dialysis fluid”1

Key results discussed in this publication

  • GDP concentrations in balance are considerably lower than in other biocompatible PD fluids.1
  • In particular, balance contains only minor amounts of the most bio-reactive GDPs 3,4-Dideoxyglucosone-3-ene (3,4-DGE) and 3-Deoxyglucosone(3-DG).1
Read the article
GDPs analysis

Product

PD fluids with lowest GDP levels – only from Fresenius Medical Care1

UltraLow GDP
balance – UltraLow GDP fluid

balance contains about 4.4 times less GDPs compared to Physioneal, specifically for the most bioactive and cytotoxic GDPs 3,4-DGE and 3-DG. Therefore, today, Fresenius Medical Care is the only provider of biocompatible PD fluids with the lowest level of GDPs.

For CAPD and APD therapy

Use of our UltraLow GDP fluids is not limited to a certain modality: balance is available for APD as well as for CAPD patients on stay•safe® and sleep•safesystems.

balance

balance is a biocompatible PD fluid with UltraLow GDP, aiming at improving patient survival by preserving the peritoneal membrane function, the residual renal function and by minimizing infection risk7,10.

  • UltraLow GDP fluid1
  • Neutral pH 

Prescribing Information

Related Content

csm_SPE001_sleep-safe-harmony_d4bdef6bd6-1

sleep•safe harmony

As individual as your patients.

1Himmele R, Jensen L, Fenn D, Ho C, Sawin D, Diaz–Buxo J. A new neutral-pH low-GDP peritoneal dialysis fluid. Peritoneal Dialysis International 2012;32(4):444-52.

2 Johnson D, EuroPD 2013.

3 Schwenger V. GDP and AGE receptors: mechanisms of peritoneal damage. Contributions to Nephrology 2006;150:77-83.

4 Cho Y, Johnson D, Badve S, Craig J, Strippoli G, Wiggins K. The impact of neutral-pH peritoneal dialysates with reduced glucose degradation products on clinical outcomes in peritoneal dialysis patients. Kidney International 2013 May 22. [Epub ahead of print]

5 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; balANZ Trial Investigators. The effects of biocompatible compared with standard peritoneal dialysis solutions on peritonitis microbiology, treatment, and outcomes: the balanz trial. Peritoneal Dialysis International 2012;32(5):497-506.

6 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; balANZ Trial Investigators. The effect of low glucose degradation product, neutral pH versus standard peritoneal dialysis solutions on peritoneal membrane function: the balANZ trial. Nephrology Dialysis Transplantation 2012;27(12):4445-53.

7 Williams J, Topley N, Craig K, Mackenzie R, Pischetsrieder M, Lage C, Passlick-Deetjen J; Euro Balance Trial Group. The Euro-Balance Trial: the effect of a new biocompatible peritoneal dialysis fluid (balance) on the peritoneal membrane. Kidney International 2004;66(1):408-18.

8 Weiss L, Stegmayr B, Malmsten G, Tejde M, Hadimeri H, Siegert C, Ahlmén J, Larsson R, Ingmann B, Simonsen O, van Hamersvelt H, Johansson A, Hylander B, Mayr M, Nilsson P, Andersson P, De los Rios T. Biocompatibility and tolerability of a purely bicarbonate-buffered peritoneal dialysis solution. Peritoneal Dialysis International 2009;29(6):630-633.

9 Montenegro J, Saracho R, Gallardo I, Martínez I, Munoz R and Quintanilla N. Use of pure bicarbonate-buffered peritoneal dialysis fluid reduces the incidence of CAPD peritonitis. Nephrology Dialysis Transplantation 2007;22(6):1703-1708.

10 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; balANZ Trial Investigators. Effects of biocompatible versus standard fluid on peritoneal dialysis outcomes. Journal of the American Society of Nephrology 2012;23(6):1097-107.

11Blake P. Balance about balANZ. Peritoneal Dialysis International 2012;32(5):493-6.