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As previously discussed, in the FY 2019 IPPS/LTCH PPS final rule (83 FR 41399), we specified a continuous, linear sliding scale formula to determine the low volume payment adjustment, as reflected in the regulations at 412.101(c)(3)(ii)

4 The resulting energy deficit and accumulation of damaged mitochondria contribute to neuronal degeneration and loss of nerve fibers

Frontino G, Succurro E, Corcoy R, Scialabba F, Poloniato A, Scavini M

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Indeed, it is generally accepted that conventional PD fluids alter the functional and anatomical integrity of the peritoneal membrane over time, by causing inflammation, neoangiogenesis and fibrosis [6]