Effect of two-chambered bicarbonate lactate-buffered peritoneal dialysis fluids on peripheral blood mononuclear cell and polymorphonuclear cell function in vitro

Sundaram, Sumuk; Cendoroglo, Miguel; Cooker, Laurinda A.; Jaber, Bertrand L.; Faict, Dirk; Holmes, Clifford J.; Pereira, Brian J.G.

doi:10.1016/s0272-6386(97)90493-5

Cited by 49 publications

(54 citation statements)

References 27 publications

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“…The tendency toward even higher values of CL in leukocytes after incubation in two-compartment PDFs must be addressed further. This finding was in contradiction to results described in several previous reports [9, 14, 15, 16, 17]. Recently, it was demonstrated that higher glucose concentrations induced an upregulation of the hexose monophosphate shunt activity and, therefore, facilitated the formation of reactive oxygen species with increasing proportions of NADPH [28].…”

Section: Discussioncontrasting

confidence: 84%

“…The impact of plasticizers is still controversial, but in vitro detrimental effects on leukocytes of levels nearly twice the values found in standard bags could be demonstrated [13, 14]. In an attempt to improve the function of the impaired immunocompetent cells, physiological buffers (bicarbonate), pH adjustment to physiological values, and reduction of GDPs by filtration instead of heat sterilization have been investigated [8, 15, 16, 17]. All above-mentioned attempts demonstrated that several functions improved with adaptation of the cited parameters to physiological ranges.…”

Section: Introductionmentioning

confidence: 99%

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A New Lactate-Based, Plasticizer-Free, Neutral Peritoneal Dialysis Fluid Provided in a Two-Compartment System: Effect on Peripheral Leukocyte Function

Alscher

Pauli‐Magnus²,

Kirchgessner³

et al. 2000

Nephron

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Background: A new neutral peritoneal dialysis fluid (PDF; Balance^®) provided in a two-compartment bag (pH 7.4, no plasticizers, minimal glucose degradation products – GDP) was investigated in comparison with a neutral control (Hanks’ balanced salt solution with gelatin 0.1%) and other PDFs with standard properties and plasticizers (Andy plus^®, pH 5.2, GDP), plasticizer free (stay safe^®, pH 5.2, GDP), and in addition plasticizer free after sterile filtration instead of heat sterilization (pH 5.2) regarding the function of peripheral blood leukocytes. Methods: Blood was drawn from 12 volunteers, and blood monocytes (MN) and polymorphonuclear leukocytes (PMNL) were collected. The cells were incubated for 30 min in control medium and the PDFs: glucose 1.5% (83 mmol/l) and 4.25% (238 mmol/l). Respiratory burst of cells was evaluated by chemiluminescence and superoxide (SO) generation after stimulation with phorbol myristate acetate. Results: In comparison with the control medium, incubation of MN in the two-compartment PDF showed preservation of respiratory burst. In contrast, the incubation of MN in standard PDF and plasticizer-free PDF showed impaired functions. The same was found for PMNL. SO anion measurement in MN and PMNL after incubation in the new two-compartment PDF also showed preservation of cell function in comparison with the control medium. The incubation of PMNL in standard PDF and plasticizer-free PDF with a high glucose content showed depressed SO anion generation. Conclusions: These in vitro data demonstrate a better preservation of in vitro phagocyte function with adaptation of pH and reduction of glucose, GDP, and plasticizers in PDFs. The best results are achieved with the two-compartment, lactate-based neutral PDF.

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Section: Discussioncontrasting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

A New Lactate-Based, Plasticizer-Free, Neutral Peritoneal Dialysis Fluid Provided in a Two-Compartment System: Effect on Peripheral Leukocyte Function

Alscher

Pauli‐Magnus²,

Kirchgessner³

et al. 2000

Nephron

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“…Their findings correlated with the presence of GDPs in aged PD solutions. Since then, several studies comparing heat-and filter-sterilized PD solutions found that heat-sterilized solutions compromised cell functions to a significantly greater extent than fluids sterilized by filtration [1,14,37,[43][44][45][46]. Recently, these observations were extended by studies in peritoneal cells indicating a significant impairment of human peritoneal mesothelial cell proliferation, viability and IL-6 release following a short-term (up to 24 h) treatment with six different GDPs [48].…”

Section: Glucose Degradation Products In Peritoneal Dialysis Fluidsmentioning

confidence: 99%

Glucose Degradation Products in Peritoneal Dialysis: From Bench to Bedside

Jörres

2003

Kidney Blood Press Res

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In continuous ambulatory peritoneal dialysis patients, treatment success is inextricably linked to the functional and morphological integrity of the peritoneal membrane. This membrane, however, is repeatedly exposed to peritoneal dialysis fluids (PDFs) with unphysiological composition (e.g., acidic pH, high glucose content, hyperosmolarity). More recently, attention of researchers and clinicians has been focused on the presence of glucose degradation products (GDPs) that are generated during heat sterilization of PDF. These GDPs were found to adversely affect peritoneal cell function both acutely and chronically. Recently, a new family of multi-chambered PDFs has been introduced into clinical practice. By keeping the glucose in a separate compartment at very low pH, the generation of GDPs during heat sterilization is markedly reduced. Initial clinical studies indicate that treatment with these novel PDFs may lead to improved clinical outcomes. The current article reviews recent experimental and clinical experience with both conventional and multi-chambered PDFs.

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“…Se han analizado factores inflamatorios [28][29][30][31] : TNF-α, interleukina 6 y una menor apoptosis. Por otra parte, las soluciones biocompatibles mejoran las defensas peritoneales y se observa que están más vivas, más activas [32][33][34] .…”

Section: Beneficios De Las Soluciones Biocompatibles Sobre Las Defensunclassified

Clinical benefits of biocompatible peritoneal dialysis solutions

Martínez

2016

RCN

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ResumenEl fallo de la membrana peritoneal se ha atribuido a la inflamación y principalmente a la exposición crónica de las soluciones convencionales de diálisis peritoneal; por tal razón, ante la limitación en el uso a largo plazo de esta técnica dialítica se investigaron nuevas soluciones, más biocompatibles, tanto del continente (plásticos) como del contenido. Respecto al contenido se retiraron los plásticos que llevaban cloruro de polivinilo y ftalatos, por sus efectos nocivos y la profunda huella ecológica de sus residuos. Las características críticas del contenido de las soluciones convencionales de DP vienen determinadas por su pH bajo, por la concentración de lactato, por la concentración alta de glucosa, por los productos de degradación de la glucosa y, por ende, por sus productos finales de la glicación, así como por la osmolaridad. Los cambios introducidos en las soluciones biocompatibles sin PVC son: pH neutro, reemplazo del tampón de lactato por bicarbonato o mezcla de ambos y mínimo contenido de PDG. Dada su mayor biocompatibilidad, las nuevas soluciones afectan menos a la membrana peritoneal, ocasionan una menor inflamación peritoneal, mejoran las defensas peritoneales locales y preservan más tiempo la función renal residual. En la mayoría de los estudios observacionales se registran todos estos beneficios clínicos a través de las soluciones biocompatibles; sin embargo, en los estudios aleatorizados no se demuestran estas enormes ventajas, aunque estos últimos contienen errores. En conclusión, como experto en usar los dos tipos de soluciones durante más de 25 años, desde nuestro punto de vista debemos aconsejar la opción biocompatible porque incorporan algunos beneficios clínicos.Palabras clave: Soluciones biocompatibles de diálisis peritoneal, cloruro de polivinilo (PVC), ftalatos, productos de degradación de la glucosa (PDG), inflamación, función renal residual.http://doi.org/10.22265/acnef.3.2.243 Abstract Peritoneal membrane failure has been related to peritoneal inflammation and to chronic exposure to conventional peritoneal dialysis solutions. That is among the main limitations for long-term peritoneal dialysis. Therefore new solutions were investigated to obtain more biocompatibility, both of plasticizers and fluids. Regarding the plasticizers, new bags are plasticizer-free without Polivinil chloride (PVC) and phtalates, which are less harmful and more ecological. The critical characteristics of fluids of conventional solutions are determined by their low pH, lactate concentration, high concentration of glucose, level of glucose degradation products and advanced glycation end products, and the high osmolarity. The new PD solutions with alternative buffers have a higher pH and fewer glucose degradation products. They have been introduced in many countries and have been shown to improve peritoneal membrane health and viability. These biocompatible solutions attenuate the peritoneal membrane alterations, cause less peritoneal inflammation, improve the peritoneal defenses and preserve the residu...

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Effect of two-chambered bicarbonate lactate-buffered peritoneal dialysis fluids on peripheral blood mononuclear cell and polymorphonuclear cell function in vitro

Cited by 49 publications

References 27 publications

A New Lactate-Based, Plasticizer-Free, Neutral Peritoneal Dialysis Fluid Provided in a Two-Compartment System: Effect on Peripheral Leukocyte Function

A New Lactate-Based, Plasticizer-Free, Neutral Peritoneal Dialysis Fluid Provided in a Two-Compartment System: Effect on Peripheral Leukocyte Function

Glucose Degradation Products in Peritoneal Dialysis: From Bench to Bedside

Clinical benefits of biocompatible peritoneal dialysis solutions

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