Effect of glucose and pyruvate in acidic and non-acidic peritoneal dialysis fluids on leukocytes cell functions

• Published in: Kidney international Vol. 51; no. 3; pp. 860 - 867
• Main Authors: Mahiout, Arezki, Matata, Bashir Mnene, Brunkhorst, Reinhard
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.03.1997; Nature Publishing
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cell Line; Chemotaxis, Leukocyte - drug effects; Cytokines - biosynthesis; Cytokines - genetics; Dialysis Solutions - adverse effects; Dialysis Solutions - chemistry; Emergency and intensive care: renal failure. Dialysis management; Glucose - adverse effects; Glucose - pharmacology; Humans; In Vitro Techniques; Intensive care medicine; Lactic Acid - adverse effects; Lactic Acid - pharmacology; Leukocytes - drug effects; Leukocytes - physiology; Leukocytes, Mononuclear - drug effects; Leukocytes, Mononuclear - physiology; Macrophages, Peritoneal - drug effects; Macrophages, Peritoneal - physiology; Medical sciences; Peritoneal Dialysis, Continuous Ambulatory - adverse effects; Peritoneal Dialysis, Continuous Ambulatory - methods; Pyruvic Acid - adverse effects; Pyruvic Acid - pharmacology; Reactive Oxygen Species - metabolism; RNA, Messenger - genetics; RNA, Messenger - metabolism; Human; Extrarenal dialysis; Leukocyte; Dialysis fluid; pH; Pyruvic acid; Chemical composition; Biological effect; Glucose; Peritoneal dialysis
• ISSN: 0085-2538; 1523-1755
• DOI: 10.1038/ki.1997.121

Effect of glucose and pyruvate in acidic and non-acidic peritoneal dialysis fluids on leukocytes cell functions. A new peritoneal dialysate containing pyruvate anions has been tested for its effects on cell functions and compared with conventional lactate and bicarbonate based solutions. The dialysate has a final pH of 5.4 to 5.6 and is composed of 1.36 to 3.86% glucose-monohydrate, 132 mmol/iter sodium, 1.75 mmol/iter calcium, 0.75 mmol/iter magnesium, 102 mmol/iter chloride and 35 mmol/iter pyruvate. For cytotoxicity testing peritoneal macrophages and peripheral blood mononuclear cells (PBMC) were exposed to conventional lactate dialysate, pyruvate dialysate, bicarbonate dialysate and a control medium RPMI 1640 (Biochrom KG, Berlin, Germany), followed by activation with different bacterial stimuli. In addition, the study further investigated the effect of varying glucose concentration in the different dialysates ranging from 0 to 3.86% and pH changes between 5.2 and 7.4 on the cytotoxicity effect on the selected cells. Mononuclear cells exposed to pyruvate-based dialysate before stimulation with endotoxin exhibited a tumor necrosis factor (TNF)-mRNA signal comparable to those of cells exposed to RPMI. In contrast, exposure to lactate-based dialysate completely inhibited TNF-mRNA synthesis. In addition, cytokine synthesis in macrophages and PBMCs after exposure to pyruvate was less inhibited when compared to the corresponding levels measured after exposure to lactate. The chemotactic response of polymorphonuclear cells and O2− generation in all tested cell types after exposure to pyruvate was found not to be inhibited, whereas a complete inhibition was observed after exposure to lactate. The results demonstrate that cytotoxicity effects of peritoneal dialysate on cell lines can be minimized by using a new dialysate formulation containing pyruvate anions instead of lactate.