0896-8608/08 $3.00 +.00 Copyright © 2008 International Society for Peritoneal Dialysis

When peritoneal dialysis (PD) was extended to thetreatment of end-stage renal disease, it could be used only for a short period, since the main complica-tion was the risk of peritoneal inflammation. Improve-ment in delivery systems has since reduced the overall rate of infection, and the number of patients that have been continuously treated by PD for more than 5 years has markedly increased. Sclerotic syndromes and peri-toneal membrane failure are the most common compli-cations currently observed in long-term PD patients. Exposure to conventional PD fluids (PDFs) with poor bio-compatibility may result in a type of “chemical peritoni-tis ” in response to a low level of “biotolerance.” Peritoneal fibroblasts, mesothelial cells, and, in particu-lar, endothelial cells act as a filtration barrier but also have an effect on intraperitoneal inflammation, as als