In vivo exposure to bicarbonate/lactate- and bicarbonate-buffered peritoneal dialysis fluids improves ex vivo peritoneal macrophage function

Mackenzie, Ruth; Jones, Suzanne; Moseley, Andrew; Holmes, Clifford J.; Argyle, Ruth; Williams, Julie; Coles, Gerald A.; Pu, Kewei; Faict, Dirk; Topley, Nicholas

doi:10.1016/s0272-6386(00)70309-x

Cited by 69 publications

(95 citation statements)

References 36 publications

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“…In humans, the data available from in vivo effects of solution components are mainly derived from ex vivo measurements of cell function in different effluent drained with varying of dwell times. [17][18][19] Over the past decade, there was increased interest for the possible identification of any measurable potential marker in PD effluent, which can be informative for the overall in vivo peritoneum status. [20,21] These markers also might represent candidate biocompatibility markers, while the changes in their concentration may indicate the host's long-term response to different dialysis solutions.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19] Over the past decade, there was increased interest for the possible identification of any measurable potential marker in PD effluent, which can be informative for the overall in vivo peritoneum status. [20,21] These markers also might represent candidate biocompatibility markers, while the changes in their concentration may indicate the host's long-term response to different dialysis solutions. To date, several candidate markers have been identified based on their relationship to changes in inflammatory status, mesothelial cell integrity, and the processes of wound healing and fibrosis.…”

Section: Discussionmentioning

confidence: 99%

“…[20,29] While the reduced GDP levels in the solutions (including the bicarbonate normal pH) are potentially responsible for the observed changes in CA125 (and possibly other markers), further direct evidence is required to substantiate this hypothesis. Reduced GDP levels in solutions have previously been demonstrated to have beneficial effects in vitro, and may offer some biocompatibility advantages in vivo compared with conventional solutions.…”

Section: Discussionmentioning

confidence: 99%

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The Alteration of Dialysate Cancer Antigen 125 Concentration Under a Biocompatible Bicarbonate Peritoneal Dialysis Solution and the Preservation of the Mesothelial Cell Viability

et al. 2008

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Background. The importance to maintain the peritoneal membrane integrity for peritoneal dialysis (PD) patients by using biocompatible solutions (with low or no glucose as osmotic factor and low in glucose degradation products-GDPs, without lactate as a buffer and with normal pH) becomes progressively more evident. The aim of the present study was to investigate the clinical effects of a novel bicarbonate-based biocompatible PD fluid, evaluating the alteration in the concentrations of dialysate marker CA125, a glucoprotein indicator of mesothelial cell mass. Patients and Methods. This is a single-center, prospective cohort study of 12 stable CAPD patients (4 women, 8 men), mean age 71.3 ± of 6.01 years, mean PD duration 31.9 ± 21.33 months, treated with the usual conventional PD solutions (with increased GDPs, low pH, and lactate as a buffer system). After a six-month period, the patients changed for the next six-month period into bicarbonate PD solutions (BicaVera, Fresenius ® ), after which they returned into their previous schema of conventional solutions for another six months. The dialysate marker of CA125 was repeatedly estimated at the beginning of the study (T0), after six months phase with the bicarbonate solutions (T6), and at the end of study (T12), after the second six-month use of the conventional PD solutions. All the samples were taken at the end of a four-hour dwell of an exchange with PD solution 2.5% glucose. Results. The dialysate mean value of CA125 at the beginning of the study (Td0-with conventional PD solutions) was 15.07 ± 5.72U/mL. After six months with bicarbonate PD solutions, the mean CA125 value increased to 111.97 ± 66.21U/mL, while the mean values dropped again to 22.72 ± 16.06 U/mL at the end of the study, after the patients' return for another six months to the conventional solutions use. There was a statistically significant difference between the mean CA125 levels at the beginning (Td0) and the middle of the study (Td6; p = 0.00079) as well as between the mean levels of CA125 in the middle (Td6) and at the end of the study (Td12; p = 0.0014). In contrast, comparing the mean dialysate values of CA125 at the beginning (Td0) and at the end of the study (Td12), no statistically significant difference was revealed (p = 0.13). Conclusions. For the use of the bicarbonate-based PD, more biocompatible solutions for six months produced a statistically significant increase in the dialysate concentration of the mesothelial cell mass indicator CA125. The decrease at the end of the study of CA125 mean value at a level similar with that observed at the beginning, after the six-month period of the conventional PD solutions, indicates that the clinical use of the new bicarbonate-based PD solutions may have an advantageous role in the preservation of peritoneal cell mass, maintaining also the integrity and longevity of the peritoneal membrane.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Alteration of Dialysate Cancer Antigen 125 Concentration Under a Biocompatible Bicarbonate Peritoneal Dialysis Solution and the Preservation of the Mesothelial Cell Viability

et al. 2008

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“…Cumulative evidences indicated that those GDPs directly cause cellular injury in cells such as fibroblasts, mesothelial cells, and mononuclear cells in vitro and ex vivo [2, 3, 4, 5]. In addition to this direct action, some GDPs with dicarbonyl residues may indirectly exert their pathological actions on the peritoneum by facilitating the generation of advanced glycation endproducts (AGEs) [6, 7, 8], which play a pathological role for the high-transport membrane, causing an ultrafiltration failure [9, 10, 11].…”

Section: Introductionmentioning

confidence: 99%

Hyper-Vascular Change and Formation of Advanced Glycation Endproducts in the Peritoneum Caused by Methylglyoxal and the Effect of an Anti-Oxidant, Sodium Sulfite

et al. 2003

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Objective: Methylglyoxal (MGO) in a heat-sterilized conventional PD solution may damage peritoneal cells directly and/or indirectly by producing advanced glycation endproducts (AGEs). This study was conducted to (a) examine the acute effect of MGO on the peritoneum (including AGE formation) and (b) study the possible AGE suppressive effect of an anti-oxidant, sodium sulfite. Method: (1) Human serum albumin (HAS) was continuously incubated with MGO (50 mM) at 37°C for as long as 14 days and the fluorescence intensity (FI) was determined (em. 440, ex. 370). (2) Three types of test solutions – (i) saline; (ii) MGO (20 mM), and (iii) MGO with sodium sulfite (30 mM) – were administered intraperitoneally to 8-week-old rats once a day for 5 consecutive days. The parietal peritoneum was examined macroscopically on the 6th day for immunostaining of anti-AGE antibodies. Result: (1) An increase in FI of HSA was observed as a function of the incubation period in the MGO solution. (2) Prominent hypervascularity and intense immunostaining of anti-AGE Ab were noted in MGO-treated rats, whereas the macroscopic alterations were suppressed in the rats that had been treated with sodium sulfite. Conclusion: MGO-induced hypervascularity and AGE formation in the peritoneum, as well as macroscopic alterations were suppressed by sodium sulfite. This may indicate that there is a risk of MGO causing a peritoneal injury and that the therapeutic potential of an anti-oxidant for this type of injury may exist.

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“…, en la medida en que se va observando un aumento de la quimiotasis y de la capacidad bactericida de los macrófagos [39][40][41][42][43][44][45] .…”

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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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In vivo exposure to bicarbonate/lactate- and bicarbonate-buffered peritoneal dialysis fluids improves ex vivo peritoneal macrophage function

Cited by 69 publications

References 36 publications

The Alteration of Dialysate Cancer Antigen 125 Concentration Under a Biocompatible Bicarbonate Peritoneal Dialysis Solution and the Preservation of the Mesothelial Cell Viability

The Alteration of Dialysate Cancer Antigen 125 Concentration Under a Biocompatible Bicarbonate Peritoneal Dialysis Solution and the Preservation of the Mesothelial Cell Viability

Hyper-Vascular Change and Formation of Advanced Glycation Endproducts in the Peritoneum Caused by Methylglyoxal and the Effect of an Anti-Oxidant, Sodium Sulfite

Clinical benefits of biocompatible peritoneal dialysis solutions

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