title: Effects of Icodextrin and Glucose Bicarbonate/Lactate-Buffered Peritoneal Dialysis Fluids on Effluent Cell Population and Biocompatibility Markers IL-6 and CA125 in Incident Peritoneal Dialysis Patients.
abstract: Icodextrin peritoneal dialysis (PD) solution has been shown to increase interleukin-6 (IL-6) levels in PD effluent as well as leukocyte and mesothelial cell count. Mesothelial cells release cancer antigen 125 (CA125), which is used as a marker of mesothelial cell mass. This 1-year prospective study was designed to compare peritoneal effluent cell population, its inflammatory phenotype and biocompatibility biomarkers IL-6 and CA125 between icodextrin (E) and glucose bicarbonate/lactate (P) based PD solutions. Using baseline peritoneal ultrafiltration capacity, 19 stable incident PD patients were allocated either to P only (N = 8) or to P plus E for the overnight dwell (N = 11). Flow cytometry was used to measure white blood cell count and differential and the expression of inflammatory molecules on peritoneal cells isolated from timed overnight peritoneal effluents. Compared to P, E effluent showed higher leukocyte (10.9 vs. 7.9), macrophages (6.1 vs. 2.5) and mesothelial cells (0.3 vs. 0.1)×10(6) /L count, as well as expression of HLA DR on mesothelial cells and IL-6 (320.5 vs. 141.2 pg/min) on mesothelial cells and CA125 appearance rate (159.6 vs. 84.3 IU/min), all P < 0.05. In the E group, correlation between IL-6 and CA125 effluent levels (r = 0.503, P < 0.05) as well as appearance rates (r = 0.774, P < 0.001) was demonstrated. No effect on systemic inflammatory markers or peritoneal permeability was found. Icodextrin PD solution activates local inflammation without systemic consequences so the clinical relevance of this observation remains obscure. Correlation between effluent IL-6 and CA125 suggests that CA125 might be upregulated due to inflammation and thus is not a reliable marker of mesothelial cell mass and/or biocompatibility.
authors.affiliation: Departments of Medicine I, Charles University Medical School and Teaching Hospital Plzen, Plzen, Czech Republic.|Biomedical Centre, Faculty of Medicine in Plzen, Charles University in Prague, Plzen, Czech Republic.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Opatrná
authors.affiliation: Departments of Medicine I, Charles University Medical School and Teaching Hospital Plzen, Plzen, Czech Republic.|Biomedical Centre, Faculty of Medicine in Plzen, Charles University in Prague, Plzen, Czech Republic.
authors.forename: Anna
authors.initials: A
authors.lastname: Pöpperlová
authors.affiliation: Biomedical Centre, Faculty of Medicine in Plzen, Charles University in Prague, Plzen, Czech Republic.|Hematooncology, Charles University Medical School and Teaching Hospital Plzen, Plzen, Czech Republic.
authors.forename: Daniel
authors.initials: D
authors.lastname: Lysák
authors.affiliation: Nuclear Medicine, Charles University Medical School and Teaching Hospital Plzen, Plzen, Czech Republic.
authors.forename: Radka
authors.initials: R
authors.lastname: Fuchsová
authors.affiliation: Biochemistry, Charles University Medical School and Teaching Hospital Plzen, Plzen, Czech Republic.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Trefil
authors.affiliation: Biomedical Centre, Faculty of Medicine in Plzen, Charles University in Prague, Plzen, Czech Republic.|Biochemistry, Charles University Medical School and Teaching Hospital Plzen, Plzen, Czech Republic.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Racek
authors.affiliation: Nuclear Medicine, Charles University Medical School and Teaching Hospital Plzen, Plzen, Czech Republic.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Topolčan
mesh_terms: D000328:Adult; D000368:Aged; D001639:Bicarbonates / Q000737:chemistry; D018394:CA-125 Antigen / Q000378:metabolism*; D015314:Dialysis Solutions / Q000737:chemistry*; D005260:Female; D005434:Flow Cytometry; D005936:Glucans / Q000737:chemistry; D005947:Glucose / Q000737:chemistry; D006801:Humans; D000077607:Icodextrin; D007249:Inflammation; D015850:Interleukin-6 / Q000378:metabolism*; D007773:Lactates / Q000737:chemistry; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods*; D011446:Prospective Studies
chemical_list: D001639:Bicarbonates; D018394:CA-125 Antigen; D015314:Dialysis Solutions; D005936:Glucans; D015850:Interleukin-6; D007773:Lactates; D000077607:Icodextrin; D005947:Glucose
keywords: Biocompatibility; Cancer antigen 125; Icodextrin interleukin-6; Peritoneal dialysis