In patients on peritoneal dialysis, peritoneal membrane alterations with inadequate peritoneal membrane function may be induced during long-term therapy. Chronic inflammation triggers malnutrition and atherosclerotic cardiovascular disease contributing to high mortality. The role of catheter, peritonitis and peritoneal dialysis fluids is argued. A neutral pH, a lesser presence of glucose degradation products generated during heat sterilization and accelerating the production of advanced glycosylation end-products (AGEs) could be reduced with better biocompatibility of peritoneal dialysis fluids.