title: Are aldehydes in heat-sterilized peritoneal dialysis fluids toxic in vitro?
abstract: OBJECTIVE
  Chemical analysis of several brands of peritoneal dialysis fluids (PD fluids) has revealed the presence of 2-furaldehyde, 5-HMF (5-hydroxymethylfuraldehyde), acetaldehyde, formaldehyde, glyoxal, and methylglyoxal. The aim of this study was to investigate if the in vitro side effects caused by glucose degradation products, mainly formed during heat sterilization, are due to any of these recently identified aldehydes.
  
  
  METHODS
  Cell growth media or sterile filtered PD fluids were spiked with different concentrations of thealdehydes.
  
  
  METHODS
  In vitro side effects were determined as the inhibition of cell growth of cultured mouse fibroblasts or stimulated superoxide radical release from human peritoneal cells.
  
  
  RESULTS
  Our results demonstrate that the occurrences of 2-furaldehyde, 5-HMF, acetaldehyde, formaldehyde, glyoxal, or methylglyoxal in heat-sterilized PD fluids are probably not the direct cause of in vitro side effects. In order to induce the same magnitude of cell growth inhibition as the heat-sterilized PD fluids, the concentrations of 2-furaldehyde, glyoxal, and 5-HMF had to be 50 to 350 times higher than those quantified in the PD fluids. The concentrations of acetaldehyde, formaldehyde, and methylglyoxal observed in the heat-sterilized PD fluids were closer to the cytotoxic concentrations although still 3 to 7 times lower.
  
  
  CONCLUSIONS
  Since none of these aldehydes caused in vitro toxicity at the tested concentrations, the toxicity found in PD fluids is likely to be due to another glucose degradation product, not yet identified. However, it is possible that these aldehydes may still have adverse effects for patients on peritoneal dialysis.
authors.affiliation: Regulatory Affairs and Preclinical Research, Gambro Lundia AB, Sweden.
authors.forename: A P
authors.initials: AP
authors.lastname: Wieslander
authors.forename: A H
authors.initials: AH
authors.lastname: Andrén
authors.forename: C
authors.initials: C
authors.lastname: Nilsson-Thorell
authors.forename: N
authors.initials: N
authors.lastname: Muscalu
authors.forename: P T
authors.initials: PT
authors.lastname: Kjellstrand
authors.forename: B
authors.initials: B
authors.lastname: Rippe
mesh_terms: D000079:Acetaldehyde / Q000633:toxicity; D000447:Aldehydes / Q000633:toxicity*; D000818:Animals; D002455:Cell Division / Q000187:drug effects; D002460:Cell Line; D002470:Cell Survival; D002478:Cells, Cultured; D015314:Dialysis Solutions / Q000633:toxicity*; D005347:Fibroblasts / Q000187:drug effects / Q000378:metabolism; D005557:Formaldehyde / Q000633:toxicity; D005662:Furaldehyde / Q000031:analogs & derivatives / Q000633:toxicity; D005947:Glucose / Q000378:metabolism; D006037:Glyoxal / Q000633:toxicity; D006801:Humans; D051379:Mice; D010529:Peritoneal Cavity / Q000166:cytology; D010530:Peritoneal Dialysis; D011765:Pyruvaldehyde / Q000633:toxicity; D013242:Sterilization; D013481:Superoxides / Q000493:pharmacokinetics
chemical_list: D000447:Aldehydes; D015314:Dialysis Solutions; D013481:Superoxides; D005557:Formaldehyde; D006037:Glyoxal; C008046:5-hydroxymethylfurfural; D011765:Pyruvaldehyde; D005662:Furaldehyde; D000079:Acetaldehyde; D005947:Glucose