title: Peritoneal dialysis with solutions low in glucose degradation products is associated with improved biocompatibility profile towards peritoneal mesothelial cells.
abstract: 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.
authors.affiliation: Department of Pathophysiology, University Medical School, ul. Swiecickiego 6, 60-781 Poznań, Poland. jwitow@amp.edu.pl
authors.forename: Janusz
authors.initials: J
authors.lastname: Witowski
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Korybalska
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Ksiazek
authors.forename: Justyna
authors.initials: J
authors.lastname: Wisniewska-Elnur
authors.forename: Achim
authors.initials: A
authors.lastname: Jörres
authors.forename: Cristina
authors.initials: C
authors.lastname: Lage
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Schaub
authors.forename: Jutta
authors.initials: J
authors.lastname: Passlick-Deetjen
authors.forename: Andrzej
authors.initials: A
authors.lastname: Breborowicz
authors.forename: Alicja
authors.initials: A
authors.lastname: Grzegorzewska
authors.forename: Andrzej
authors.initials: A
authors.lastname: Ksiazek
authors.forename: Tomasz
authors.initials: T
authors.lastname: Liberek
authors.forename: Monika
authors.initials: M
authors.lastname: Lichodziejewska-Niemierko
authors.forename: Maria
authors.initials: M
authors.lastname: Majdan
authors.forename: Boleslaw
authors.initials: B
authors.lastname: Rutkowski
authors.forename: Tomasz
authors.initials: T
authors.lastname: Stompór
authors.forename: Wladyslaw
authors.initials: W
authors.lastname: Sulowicz
mesh_terms: 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
chemical_list: D015312:Hemodialysis Solutions; D005947:Glucose