Effects of new peritoneal dialysis solutions on leukocyte recruitment in the rat peritoneal membrane.
OBJECTIVE
Peritonitis remains a principal cause of dropout in peritoneal dialysis (PD). The physiological host response to a peritoneal infection involves a rise in numbers of circulating leukocytes to the peritoneal cavity. We evaluated the effects of (1) conventional peritoneal dialysis fluid (PDF), (2) bicarbonate-based PDF, low in glucose degradation products, and (3) non-glucose PDF on peritoneal leukocyte recruitment in response to an inflammatory stimulus using intravital microscopy.


METHODS
The visceral peritoneum was exposed to EBSS, conventional lactate-buffered and bicarbonate/lactate-buffered glucose-based PDF and three lactate-buffered non-glucose PDF-icodextrin, amino acid-based PDF and amino acid/glycerol-based PDF. The number of rolling, adhering and extravasated leukocytes and leukocyte rolling velocity was assessed at different time intervals after stimulation with lipopolysaccharide (LPS).


RESULTS
Exposure to LPS dissolved in EBSS dramatically increased the number of rolling, adhering and extravasated leukocytes and decreased leukocyte rolling velocity. Conventional PDF completely abolished LPS-induced leukocyte recruitment. Bicarbonate/lactate-buffered PDF only minimally affected the process of leukocyte recruitment, whereas icodextrin PDF resulted in partial inhibition of the immune response. The amino acid-based and the amino acid/glycerol-based PDF inhibited leukocyte recruitment to a similar extent as conventional PDF.


CONCLUSIONS
Bicarbonate/lactate-buffered PDF has superior biocompatibility towards peritoneal host defense, in spite of its high glucose concentrations. Lactate-buffered non-glucose containing PDF has substantial inhibitory effects on leukocyte recruitment, indicating that the bioincompatibility of high lactate concentrations and/or low pH may not be underestimated.
Mortier
Siska
S
Renal Division, University Hospital, Gent, Belgium.
Faict
Dirk
D
Gericke
Marion
M
Lameire
Norbert
N
De Vriese
An
A
D000596:Amino Acids / Q000032:analysis; D000818:Animals; D001639:Bicarbonates / Q000032:analysis; D001794:Blood Pressure / Q000187:drug effects; D015314:Dialysis Solutions / Q000737:chemistry / Q000494:pharmacology*; D005260:Female; D005947:Glucose / Q000032:analysis; D005990:Glycerol / Q000032:analysis; D006400:Hematocrit; D006863:Hydrogen-Ion Concentration; D007773:Lactates / Q000032:analysis; D007962:Leukocytes / Q000187:drug effects* / Q000502:physiology*; D008070:Lipopolysaccharides / Q000494:pharmacology; D008422:Materials Testing; D010529:Peritoneal Cavity / Q000166:cytology*; D010530:Peritoneal Dialysis; D051381:Rats; D017208:Rats, Wistar
D000596:Amino Acids; D001639:Bicarbonates; D015314:Dialysis Solutions; D007773:Lactates; D008070:Lipopolysaccharides; D005947:Glucose; D005990:Glycerol