title: Evidence for less irritation to the peritoneal membrane in rats dialyzed with solutions low in glucose degradation products.
abstract: BACKGROUND
  Acidic pH and the presence of glucose degradation products (GDP) are believed to compromise the biocompatibility of peritoneal dialysis fluids (PDF). The present study examines the effects of long-term exposure to GDP and low pH by comparing conventional PDF and a new, neutral pH, low GDP solution.
  
  
  METHODS
  All experiments were performed using a chronic infusion model of dialysis in nonuremic rats. The animals were treated for 6 weeks with 2 daily injections of 4.25% glucose-containing PDF. The following PDF were tested: CAPD3 (single-chamber bag, low pH, high GDP), CAPD3 pH 7.4 (single-chamber bag, neutral pH, high GDP), CAPD3-Balance (double-chamber bag, neutral pH, low GDP). All test solutions were obtained from Fresenius Medical Care, Bad Homburg, Germany.
  
  
  RESULTS
  After 6 weeks of exposure, peritoneal permeability to water, urea, creatinine, glucose, and sodium, assessed by peritoneal equilibration test, was similar in all groups. However, compared to other PDF, dialysis with CAPD3-Balance was associated with reduced concentrations of protein and hyaluronan in the dialysate, decreased peritoneal eosinophilia, and reduced dialysate levels of chemokines CCL2/MCP-1 and CCL5/RANTES. Morphologic changes in the peritoneal membrane of CAPD3-Balance-treated animals were much less pronounced and included reduced vascular density, preservation of the mesothelial monolayer and intercellular junction, and no reduplication of the submesothelial basement membrane.
  
  
  CONCLUSIONS
  A new generation of PDF with physiologic pH and low GDP level produce less irritation to the peritoneal membrane and better preserve its structural integrity. This effect seems to be related predominantly to minimized GDP concentrations.
authors.affiliation: Department of Pathophysiology, University of Medical Sciences, Pozńan, Poland. kwt@tobis.pl
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Wieczorowska-Tobis
authors.forename: Renata
authors.initials: R
authors.lastname: Brelinska
authors.forename: Janusz
authors.initials: J
authors.lastname: Witowski
authors.forename: Jutta
authors.initials: J
authors.lastname: Passlick-Deetjen
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Schaub
authors.forename: Holger
authors.initials: H
authors.lastname: Schilling
authors.forename: Andrzej
authors.initials: A
authors.lastname: Breborowicz
mesh_terms: D000818:Animals; D005947:Glucose / Q000008:administration & dosage* / Q000378:metabolism; D015312:Hemodialysis Solutions / Q000009:adverse effects*; D006863:Hydrogen-Ion Concentration; D008297:Male; D008854:Microscopy, Electron; D010537:Peritoneum / Q000187:drug effects* / Q000473:pathology / Q000648:ultrastructure; D010538:Peritonitis / Q000139:chemically induced* / Q000473:pathology; D051381:Rats; D017208:Rats, Wistar
chemical_list: D015312:Hemodialysis Solutions; D005947:Glucose