• Changes in HbA1c (glycated haemoglobin) [ Time Frame: 6 months ]
  Change from baseline value
• Insulin [ Time Frame: 6 months ]
  Changes from the baseline value
• LDL cholesterol [ Time Frame: 6 months ]
  Changes from the baseline value
• HDL cholesterol [ Time Frame: 6 months ]
  Change from the baseline value
• Serum triglycerides [ Time Frame: 6 months ]
  Change from the baseline value
• Total cholesterol [ Time Frame: 6 months ]
  Changes from the baseline
• Hemoglobin [ Time Frame: 6 months ]
  Changes from the baseline value
• EPO requirements [ Time Frame: 6 months ]
  Change from the baseline
• Fatigue measured through a validated instrument [ Time Frame: 6 months ]
  Changes from the baseline
• Peritoneal ultrafiltration [ Time Frame: 6 months ]
  Changes from baseline
• Diuresis (or 24 hours urinary volume) [ Time Frame: 6 months ]
  Changes from baseline
• Residual renal function [ Time Frame: 6 months ]
  Changes from baseline - measured as the arithmetic mean of urinary urea and creatinine clearance
• Adverse Events [ Time Frame: 6 months ]
  Information about all adverse events, whether volunteered by the patient, discovered by investigator questioning, or detected through physical examination, laboratory test or other means, will be collected, recorded and followed as appropriate.

• Changes in glycemic control medication use [ Time Frame: 6 months ]
  Change in medication dose and use in diabetic patients
• Insulin [ Time Frame: 6 months ]
  Changes from the baseline value
• LDL cholesterol [ Time Frame: 6 months ]
  Changes from the baseline value
• HDL cholesterol [ Time Frame: 6 months ]
  Change from the baseline value
• Serum triglycerides [ Time Frame: 6 months ]
  Change from the baseline value
• Hemoglobin [ Time Frame: 6 months ]
  Changes from the baseline value
• EPO requirements [ Time Frame: 6 months ]
  Change from the baseline
• Quality of Life measured through a validated instrument [ Time Frame: 6 months ]
  Changes from the baseline
• Adverse Events [ Time Frame: 6 months ]
  Information about all adverse events, whether volunteered by the patient, discovered by investigator questioning, or detected through physical examination, laboratory test or other means, will be collected, recorded and followed as appropriate.

• Drug: XyloCore Low Strenght, XyloCore Medium Strenght, XyloCore High Strenght
  XyloCore Low Strenght: 0.7% Xylitol, 0.5% Glucose, and 0.02% L-carnitine - or - XyloCore Medium Strenght: 1.5% Xylitol, 0.5% Glucose, and 0.02% L-carnitine - or - XyloCore High Strenght: 2.0% Xylitol, 1.5% Glucose, and 0.02% L-carnitine
  Other Name: XyloCore 0.7 or 1.5 or 2.0
• Drug: 1.36%, 1.5%, 2.27%, 2.5%, 3.86%, 2.25% Glucose PD Solution
  Physioneal 35 or 40 (including Clear-Flex bag), Fixioneal 35 or 40, Dianeal or Dianeal Low Calcium have 1.36%, 2.27% or 3.86% glucose; Balance, Bicavera, Bicanova or Equibalance have 1.25%, 2.3%, 4.5% glucose.
  Other Name: Physioneal 40 or 35, Fixioneal 40 or 35, Dianeal, Balance, Bicavera, Bicanova, Equibalance

• Experimental: XyloCore peritoneal dialysis solution
  Patients will receive 2 to 3 daily (short-dwell) exchanges with XyloCore of an osmotic strength comparable to their pre-randomization prescription of glucose peritoneal dialysis solution (XyloCore Low, Medium and High Strenght have an osmotic strength comparable to Physioneal, Fixioneal or Dianeal 1.36%, 2.27%, 3.86% glucose, respectively, and Balance, Bicavera, Bicanova or Equibalance with 1.5%, 2.5%, 4.25% glucose, respectively). All patients will receive Extraneal (7.5% Icodextrin) for nocturnal (long-dwell) exchange.
  Intervention: Drug: XyloCore Low Strenght, XyloCore Medium Strenght, XyloCore High Strenght
• Active Comparator: Glucose peritoneal dialysis solution
  Patients randomized to glucose solution will continue the 2 to 3 daily (short-dwell) exchanges of Physioneal 40 or 35, Fixioneal 40 or 35 or Dianeal (1.36%, 2.27%, 3.86% glucose), Balance, Bicavera, Bicanova or Equibalance (1.5%, 2.5%, 4.25% glucose) with the same osmotic strength of their pre-randomization prescription. All patients will receive Extraneal (7.5% Icodextrin) for nocturnal (long-dwell) exchange.
  Intervention: Drug: 1.36%, 1.5%, 2.27%, 2.5%, 3.86%, 2.25% Glucose PD Solution

Inclusion Criteria:

• Age ≥18 years
• Diagnosed with ESRD and treated with CAPD in the last 3 months
• In a stable clinical condition during the 3 months before screening as demonstrated by the absence of non-elective hospitalization and major cardiovascular events
• Have not experienced peritonitis episodes in the last 3 months
• In treatment with prescribed Extraneal (nocturnal exchange bag solution) for at least 1 month;
• In treatment with 2 to 3 diurnal exchange bag solution of prescribed Phisioneal (including Clear-Flex bag), Fixioneal, Dianeal or Dianeal Low Calcium (1.36%, 2.27% or 3.86% glucose), or Balance, Bicavera, Bicanova or Equibalance (1.25%, 2.3%, 4.5% glucose)
• Kt/V urea measurement > 1.7 per week at Baseline Visit
• Followed/treated by the participating clinical Center/Investigator in the last three months
• Understanding the nature of the study and providing their informed consent to participation.

Exclusion Criteria:

• History of drug or alcohol abuse in the six months prior to entering the protocol
• In treatment with androgens
• Clinically significant abnormal liver function test (ɣ-GT > 4 times the upper normal limit)
• Acute infectious conditions (i.e.: pulmonary infection, acute hepatitis, high or low urinary tract infections, renal parenchymal infection, pericarditis, etc)
• Expected patient's survival shorter than the trial duration
• History of L-Carnitine therapy or use in the month prior to entering the protocol
• Have used any investigational drug in the 3 months prior to entering the protocol
• Female patients who are pregnant or breast-feeding.
• Female patients of childbearing age (less than 24 months after the last menstrual cycle) who do not use adequate contraception
• Patients affected by Primary Hyperoxaluria, including carrier heterozygous
• Patients with serum levels of uric acid > 7.2 mg/dl (male and postmenopausal women) or > 6.0 mg/dl (premenopausal women)
• Patients with a major cardiovascular event in the last 3 months
• Patients with advanced cardiac failure (NYHA 4)
• Patients with advanced COPD, characterized by GOLD Guidelines class 3, severe (FEV1/FVC ˂ 0.70; 30% ≤ FEV1 ˂50% predicted) and class 4, very severe (FEV1/FVC ˂ 0.70; FEV1 ˂30% predicted or FEV1 ˂ 50% predicted plus chronic respiratory failure)