Nephrology Dialysis Transplantation, Vol 12, Issue 3 543-549, Copyright © 1997 by Oxford University Press
A Jorres, GM Gahl, K Ludat, U Frei and J Passlick-Deetjen
BACKGROUND: Conventional lactate-buffered peritoneal dialysis fluids
containing glucose as the osmotic agent have been shown to compromise
important peritoneal host defence functions. The current study employed an
in vitro model using activated peripheral blood mononuclear leukocytes
(PBMC) for the preclinical biocompatibility assessment of a novel
bicarbonate-buffered peritoneal dialysis fluid containing 1.0% amino acids
as the osmotic agent. METHODS: PBMC (5 x 10(6)/ml) were pre- exposed (10-30
mm, 37 degrees C) to bicarbonate-buffered 1% amino-acid solution,
bicarbonate- or lactate-buffered 1.5% glucose fluid, or control medium
(RPMI). The cells were then washed and stimulated for 2 h at 37 degrees C
in RPMI containing 100 ng/ml E.coli endotoxin from strain O55:B5. The
cytokines IL-6 and TNF alpha in cell supernatants were assessed using
specific enzyme immunoassays, cytokine mRNA expression by reverse
transcription polymerase chain reaction. RESULTS: Short, i.e. 10 min,
exposure to conventional, lactate-buffered glucose fluid resulted in a
significant and time-dependent inhibition of cytokine release and mRNA
expression by activated PBMC, whereas the cytokine response was improved
even following prolonged (up to 2 h) exposure to bicarbonate-buffered 1%
amino-acid solution or bicarbonate- buffered 1.5% glucose fluid.
CONCLUSIONS: Our results suggest that very short, i.e. potentially
clinically relevant, exposure to conventional dialysis fluid impairs the
cytokine response by activated leukocytes. In this respect, the use of
bicarbonate-buffered solutions containing 1.0% amino acids or 1.5% glucose
may result in improved biocompatibility properties.
ORIGINAL ARTICLES
In vitro biocompatibility evaluation of a novel bicarbonate-buffered amino-acid solution for peritoneal dialysis
Abteilung fur Innere Medizin mit Schwerpunkt Nephrologie und Internistische Intensivmedizin, Virchow-Klinikum der Humboldt- Universitat zu Berlin, Germany.
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