title: A comparison of the biocompatibility of phosphate-buffered saline and dianeal 3.86% in the rat model of peritoneal dialysis.
abstract: Phosphate-buffered saline (PBS), an isotonic solution with a physiologic pH can be considered an example of a biocompatible dialysis fluid. This study compared the biocompatibility of PBS with that of Dianeal 3.86% (Baxter Healthcare Corporation, Deerfield, IL, U.S.A.), using a model of peritoneal dialysis in the rat. In an acute experiment, after catheter implantation, rats were infused on day 1 with PBS, on day 5 with standard dialysis solution (Dianeal 3.86%), and on day 7 again with PBS. When rats were injected with Dianeal 3.86%, the inflammatory reaction was suppressed as compared with PBS. The cell count was lower with Dianeal (-85%, p < 0.001), the neutrophil:macrophage ratio in dialysate was 80% lower (p < 0.01), total protein concentration in the Dianeal dialysate was 73% lower (p < 0.01), and the dialysate nitrite level was 45% lower (p < 0.01). In a chronic experiment, after catheter implantation, rats were dialyzed for four weeks with PBS or with Dianeal 3.86%. At the end of the study, a 1-hour peritoneal equilibration test (PET) was performed. As evaluated on a semiquantitative scale, macroscopic changes in the peritoneum were more severe in rats exposed to PBS than in those exposed to Dianeal 3.86% (8.6 +/- 3.2 vs 5.2 +/- 2.6, p < 0.05). The thickness of the visceral peritoneum was comparable in both groups; but, in PBS-treated rats, the peritoneal interstitium contained more inflammatory cells and more new vessels. During the 1-hour PET, peritoneal permeability to water and solutes was comparable in the two groups. Despite a more physiologic composition, PBS is a less biocompatible peritoneal dialysis solutions than is standard, acidic, hypertonic dialysis solution.
authors.affiliation: University Medical School of Poznan, Poznan, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Wieczorowska-Tobis
authors.forename: A
authors.initials: A
authors.lastname: Polubinska
authors.forename: A
authors.initials: A
authors.lastname: Breborowicz
authors.forename: D G
authors.initials: DG
authors.lastname: Oreopoulos
mesh_terms: D000818:Animals; D001672:Biocompatible Materials; D002021:Buffers; D002452:Cell Count; D015314:Dialysis Solutions / Q000009:adverse effects / Q000737:chemistry; D006863:Hydrogen-Ion Concentration; D006982:Hypertonic Solutions; D007552:Isotonic Solutions; D008264:Macrophages / Q000473:pathology; D008297:Male; D009504:Neutrophils / Q000473:pathology; D009573:Nitrites / Q000032:analysis; D010530:Peritoneal Dialysis; D010537:Peritoneum / Q000378:metabolism / Q000473:pathology; D010710:Phosphates; D011506:Proteins / Q000032:analysis; D051381:Rats; D017208:Rats, Wistar; D012965:Sodium Chloride
chemical_list: D001672:Biocompatible Materials; D002021:Buffers; D015314:Dialysis Solutions; D006982:Hypertonic Solutions; D007552:Isotonic Solutions; D009573:Nitrites; D010710:Phosphates; D011506:Proteins; D012965:Sodium Chloride