How to reduce 3-deoxyglucosone and acetaldehyde in peritoneal dialysis fluids.
OBJECTIVE
3-Deoxyglucosone (3-DG) and acetaldehyde were found to be the major reactive carbonyl compounds in conventional heat-sterilized peritoneal dialysis fluids (PDFs). The aim of this study was to identify factors in the production of PDFs promoting or inhibiting the formation of acetaldehyde and 3-DG.


METHODS
Single-chamber bag PDFs with different buffer systems and pH values were analyzed for acetaldehyde. 3-Deoxyglucosone was determined in double-chamber bag PDFs with different pH values, in commercially available samples, and in double-chamber products stored under defined conditions.


RESULTS
Acetaldehyde was found in the presence of lactate and malate, whereas in 2-hydroxybutanoate-buffered solution propionaldehyde was detected instead. Between pH 5.0 and 6.0 the acetaldehyde content in lactate-buffered solutions increased strongly. The concentration of 3-DG in the chamber containing glucose In double-chamber bags increased between pH 3.0 and 5.0 by a factor of 6. 3-Deoxyglucosone concentrations in commercially available products vary greatly, reflecting the different pH values of these products. A time- and temperature-dependent reaction leads to a reduction in 3-DG and an increase in 5-hydroxymethyl-furan-2-carbaldehyde during storage.


CONCLUSIONS
Acetaldehyde is produced by a reaction that requires both lactate and glucose. Thus, its formation can be prevented by a separation of the reaction partners, glucose and lactate, in a double-chamber bag. In double-chamber bags, pH greatly influences the formation of 3-DG. Minimal formation is observed in the region of pH 3.0. This finding should be taken into account for the development of new double-chamber bag PDFs.
Zimmeck
Thomas
T
Fresenius Medical Care Deutschland GmbH, St Wendel, Germany.
Tauer
Andreas
A
Fuenfrocken
Michael
M
Pischetsrieder
Monika
M
D000079:Acetaldehyde / Q000138:chemical synthesis* / Q000737:chemistry; D002849:Chromatography, Gas; D002851:Chromatography, High Pressure Liquid; D003847:Deoxyglucose / Q000031:analogs & derivatives* / Q000138:chemical synthesis* / Q000737:chemistry; D015314:Dialysis Solutions / Q000138:chemical synthesis* / Q000737:chemistry; D005663:Furans / Q000737:chemistry; D005947:Glucose / Q000737:chemistry; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007773:Lactates / Q000737:chemistry; D010530:Peritoneal Dialysis; D013997:Time Factors
C438025:5-hydroxymethyl-2-furancarboxaldehyde; D015314:Dialysis Solutions; D005663:Furans; D007773:Lactates; D003847:Deoxyglucose; C016350:3-deoxyglucosone; D000079:Acetaldehyde; D005947:Glucose