In the first PD Exchange podcast episode of 2025, Dr. Nikhil Shah and Dr. Jeff Perl introduce a groundbreaking topic—the ELIXIR trial to evaluate Xylocore, an innovative glucose-sparing solution for peritoneal dialysis. They are joined by experts Dr. Arduino Arduini and Dr. Richard Corbett, who delve into the formulation, rationale, and design of Xylocore, detailing the incorporation of xylitol and carnitine to optimize dialysis outcomes while minimizing glucose exposure. The discussion covers the scientific, clinical, and logistical aspects of the ongoing phase three trial, implications for diabetic patients, and future research directions, emphasizing the potential cardiometabolic benefits and improved patient engagement in PD therapy.