title: Heat sterilization of peritoneal dialysis solutions influences ingestive behavior in non-uremic rats.
abstract: BACKGROUND
  The appetite inhibitory effect of glucose-based peritoneal dialysis (PD) solutions may be due to glucose as such, or the hyperosmolality of the PD solution, or an effect of glucose degradation products (GDPs) formed in the PD solution during heat sterilization. This was studied in an experimental appetite model in rat.
  
  
  METHODS
  The effect of different experimental PD solutions on ingestive behavior was investigated in non-uremic rats equipped with an implanted intraoral (i.o.) cannula through which a 1 mol/L sucrose solution was infused during tests. The amount of intake was recorded at 30 min after rats were infused intraperitoneally (IP) with 30 mL of different solutions. This method allowed an accurate and reproducible analysis of i.o. intake. The experimental PD solutions tested included (1) glucose based PD solutions with different glucose concentrations, sterilized by heat or microbiological filter, (2) glucose- and mannitol-based PD solutions with the same osmolality, sterilized by heat or microbiological filter; and (3) glucose based PD solutions, using different pH values (pH 3.0, pH 5.5 or pH 7.4) during heat sterilization.
  
  
  RESULTS
  Following IP infusion of solutions, (1) the i.o. intake was significantly inhibited by glucose based, heat sterilized PD solutions and the degree of appetite suppression was related to the concentration of dialysate glucose in a dose-dependent way; (2) the i.o. intake was significantly less suppressed by filter sterilized than by heat sterilized glucose-based solutions; (3) the i.o. intake was significantly less following the IP infusion of glucose-based than following the mannitol-based heat sterilized solutions; however, i.o. intake did not differ between the glucose-based and mannitol-based filter sterilized solutions; and (4) furthermore, the degree of suppression of i.o. intake induced by glucose-based PD solutions was influenced by the pH value during heat sterilization. The lower the pH of the PD solution during heat sterilization, the higher the i.o. intake.
  
  
  CONCLUSIONS
  The IP infusion of glucose-based heat-sterilized PD solutions inhibited food intake in this experimental appetite model, and the degree of suppression depended on the concentration of dialysate glucose and the pH of the solution during heat sterilization. The results suggest that GDPs formed during heat sterilization may exert a more adverse effect than glucose itself on ingestive behavior, and that a reduction of the concentration of GDPs in the PD solution using filter sterilization or a low pH value in the PD solution during heat sterilization may improve food intake.
authors.affiliation: Divisions of Baxter Novum and Renal Medicine, Karolinska Institutet, K-56 Huddinge University Hospital, S-14186 Huddinge, Stockholm, Sweden.
authors.forename: Zhi-Hua
authors.initials: ZH
authors.lastname: Zheng
authors.forename: Björn
authors.initials: B
authors.lastname: Anderstam
authors.forename: Abdul Rashid
authors.initials: AR
authors.lastname: Qureshi
authors.forename: Olof
authors.initials: O
authors.lastname: Heimbürger
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.forename: Per
authors.initials: P
authors.lastname: Södersten
authors.forename: Jonas
authors.initials: J
authors.lastname: Bergström
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
mesh_terms: D000818:Animals; D002021:Buffers; D015314:Dialysis Solutions / Q000737:chemistry / Q000494:pharmacology*; D004234:Diuretics, Osmotic / Q000494:pharmacology; D005247:Feeding Behavior / Q000187:drug effects*; D005950:Glucose Solution, Hypertonic; D006358:Hot Temperature; D006863:Hydrogen-Ion Concentration; D007263:Infusions, Parenteral; D008297:Male; D008353:Mannitol / Q000494:pharmacology; D010530:Peritoneal Dialysis; D051381:Rats; D017208:Rats, Wistar; D013242:Sterilization; D014511:Uremia
chemical_list: D002021:Buffers; D015314:Dialysis Solutions; D004234:Diuretics, Osmotic; D005950:Glucose Solution, Hypertonic; D008353:Mannitol