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Physioneal is a biocompatible peritoneal dialysis (PD) solution developed by Baxter Healthcare, designed to improve upon conventional acidic, lactate-buffered solutions. It features a neutral pH (7.4) and a unique bicarbonate/lactate buffer system, which more closely approximates physiological conditions. The solution is typically supplied in a dual-chamber bag to separate glucose from the buffer during sterilization, thereby minimizing the formation of glucose degradation products (GDPs). GDPs are implicated in peritoneal membrane damage, including mesothelial cell loss, angiogenesis, and fibrosis. Physioneal is indicated for the treatment of chronic kidney disease (CKD) in patients requiring continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD). Clinical evidence, including the Impendia trial, suggests that Physioneal, as part of a glucose-sparing regimen, may also offer metabolic benefits for diabetic patients on PD by reducing systemic glucose exposure.
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