Prevention of peritoneal sclerosis: a new proposal to substitute glucose with carnitine dialysis solution (biocompatibility testing in vitro and in rabbits).
OBJECTIVE
Commercial glucose peritoneal dialysis solutions expose the peritoneum to hyperosmolar glucose containing variable amounts of non-enzymic breakdown products of glucose. These solutions are toxic for the peritoneum. The aim of the present study is to compare in vitro and in vivo characteristics of a new dialysis solution containing carnitine, a naturally occurring compound, as substitute of glucose.


METHODS
We compared in vitro and in the rabbit a new peritoneal dialysis solution containing carnitine, with two standard bicarbonate glucose peritoneal dialysis solutions and a solution containing icodextrin.


RESULTS
In vitro and in vivo the solution containing carnitine seems to be more biocompatible than standard glucose solutions and those containing icodextrin.


CONCLUSIONS
In our study the peritoneal dialysis solution containing carnitine seems to prevent the mesothelial changes observed with solutions containing glucose. Since carnitine has been extensively studied and seems to be well tolerated by hemodialysis patients, even at high doses for long periods, clinical trials in humans may be planned in the near future.
Gaggiotti
E
E
Department of Nephrology and Dialysis, University Hospital of Siena, 53100 Siena, Italy. e.gaggiotti@ao-siena.toscana.it
Arduini
A
A
Bonomini
M
M
Valentini
G
G
Sacchi
G
G
Sansoni
E
E
Salvo
D
D
Di Paolo
N
N
D000818:Animals; D002331:Carnitine / Q000032:analysis*; D002478:Cells, Cultured; D015314:Dialysis Solutions / Q000009:adverse effects / Q000737:chemistry*; D015232:Dinoprostone / Q000378:metabolism; D004847:Epithelial Cells / Q000187:drug effects / Q000378:metabolism / Q000648:ultrastructure; D005947:Glucose / Q000032:analysis*; D006801:Humans; D066298:In Vitro Techniques; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D010530:Peritoneal Dialysis; D010537:Peritoneum / Q000187:drug effects* / Q000473:pathology*; D010713:Phosphatidylcholines / Q000378:metabolism; D010743:Phospholipids / Q000378:metabolism; D011817:Rabbits; D012598:Sclerosis
D015314:Dialysis Solutions; D010713:Phosphatidylcholines; D010743:Phospholipids; D007770:L-Lactate Dehydrogenase; D005947:Glucose; D015232:Dinoprostone; D002331:Carnitine