Peritoneal dialysis with solutions low in glucose degradation products is associated with improved biocompatibility profile towards peritoneal mesothelial cells.
BACKGROUND
In vitro experiments point to a better biocompatibility profile of new pH-neutral peritoneal dialysis fluids (PDFs) containing low levels of glucose degradation products (GDPs). The present study examines the impact on human peritoneal mesothelial cells (HPMCs) of equilibrated dialysates obtained during dialysis with either conventional or new PDFs.


METHODS
Peritoneal dialysate was collected from 17 patients participating in a randomized, controlled, cross-over trial comparing a pH-neutral low-GDP solution (Balance) to a conventional solution (S-PDF). All patients were treated sequentially for 3 months with both PDFs. At the end of each treatment phase, peritoneal effluent was drained after a timed 10 h dwell. Samples of dialysate were then mixed with standard culture medium and added to in vitro cultures of HPMCs from healthy donors. Cells were assessed for proliferation, viability and cytokine release.


RESULTS
Proliferation and viability of HPMCs were better preserved in the presence of effluent obtained during dialysis with Balance (P<0.046 and P<0.035, respectively). The proliferative response of HPMCs correlated with the concentration of fibronectin in dialysates (P = 0.0024). Effluent drained following a 3 month dialysis with Balance contained significantly increased levels of fibronectin (P = 0.004) and CA125 antigen (P = 0.0004) compared with S-PDF. There was no significant difference in constitutive and stimulated cytokine (IL-6, MCP-1, VEGF) synthesis by HPMCs treated with either Balance- or S-PDF-derived effluents.


CONCLUSIONS
These results suggest that therapy with new pH-neutral low-GDP solutions contribute to an intraperitoneal milieu that improves mesothelial cell proliferation and viability. It may positively impact on the preservation of the peritoneal membrane integrity during long-term dialysis.
Witowski
Janusz
J
Department of Pathophysiology, University Medical School, ul. Swiecickiego 6, 60-781 Poznań, Poland. jwitow@amp.edu.pl
Korybalska
Katarzyna
K
Ksiazek
Krzysztof
K
Wisniewska-Elnur
Justyna
J
Jörres
Achim
A
Lage
Cristina
C
Schaub
Thomas P
TP
Passlick-Deetjen
Jutta
J
Breborowicz
Andrzej
A
Grzegorzewska
Alicja
A
Ksiazek
Andrzej
A
Liberek
Tomasz
T
Lichodziejewska-Niemierko
Monika
M
Majdan
Maria
M
Rutkowski
Boleslaw
B
Stompór
Tomasz
T
Sulowicz
Wladyslaw
W
D000328:Adult; D000368:Aged; D002455:Cell Division; D002478:Cells, Cultured; D004847:Epithelial Cells; D005260:Female; D005947:Glucose / Q000008:administration & dosage*; D015312:Hemodialysis Solutions; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010537:Peritoneum / Q000166:cytology*; D016032:Randomized Controlled Trials as Topic
D015312:Hemodialysis Solutions; D005947:Glucose