title: [Biocompatibility of peritoneal dialysis fluids].
abstract: Repeated and long-term exposure to conventional glucose-based peritoneal dialysis fluids (PDFs) with poor biocompatibility plays a central role in the pathogenesis of the functional and structural changes of the peritoneal membrane. We have used immortalized human peritoneal mesothelial cells in culture to assess in vitro the biocompatibility of PDFs. Low pH, high glucose concentration and heat sterilization represent major factors of low biocompatibility. Two recent groups of glucose derivatives have been described. Glucose degradation products (GDPs) are formed during heat sterilization (glycoxidation) and storage. GDPs can bind protein and form AGEs (Advanced Glycation End-products), which can also result from the binding of glucose to free NH2 residues of proteins (glycation). The physiological pH, and the separation of glucose during heat sterilization (low GDP content) in the most recent PDFs dramatically increase the biocompatibility. The choice of PD programs with high biocompatibility PDFs allows preserving the function of the peritoneal membrane. Improvement of PDF biocompatibility may limit the occurrence of chronic chemical peritonitis and may allow long-term PD treatment.
authors.affiliation: Clinique néphrologique, hôpital Albert-Calmette, CHRU, 59037 Lille cedex, France. eboulanger@chru-lille.fr
authors.forename: Eric
authors.initials: E
authors.lastname: Boulanger
authors.forename: Olivier
authors.initials: O
authors.lastname: Moranne
authors.forename: Marie-Paule
authors.initials: MP
authors.lastname: Wautier
authors.forename: Jean-Phillipe
authors.initials: JP
authors.lastname: Rougier
authors.forename: Pierre
authors.initials: P
authors.lastname: Ronco
authors.forename: Dominique
authors.initials: D
authors.lastname: Pagniez
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Wautier
mesh_terms: D001672:Biocompatible Materials; D015314:Dialysis Solutions / Q000009:adverse effects / Q000592:standards*; D005947:Glucose; D017127:Glycation End Products, Advanced / Q000009:adverse effects; D006801:Humans; D010529:Peritoneal Cavity / Q000503:physiopathology; D010530:Peritoneal Dialysis / Q000592:standards*; D012996:Solutions
chemical_list: D001672:Biocompatible Materials; D015314:Dialysis Solutions; D017127:Glycation End Products, Advanced; D012996:Solutions; D005947:Glucose