A. Mahiout et R. Brunkhorst, PYRUVATE ANIONS NEUTRALIZE PERITONEAL DIALYSATE CYTOTOXICITY, Nephrology, dialysis, transplantation, 10(3), 1995, pp. 391-394
A new peritoneal dialysate containing pyruvate anions was developed in
order to avoid cytotoxic effect of conventional lactate-based dialysa
te. The dialysate has a final pH of 5.4 to 5.6 and is composed of 1.36
-3.86% glucose-monohydrate; 132 mmol/l sodium; 1.75 mmol/l calcium; 0.
75 mmol/l magnesium; 102 mmol/l chloride and 35 mmol/l pyruvate. For c
ytotoxicity testing peritoneal macrophages, and mesothelial cells (MC)
were exposed to conventional lactate dialysate, and pyruvate dialysat
e, We investigated the O-2(-) generation and cytokine synthesis after
endotoxin stimulation in peritoneal macrophages and the proliferation
of mesothelial cells of cultured human MC. After exposure to lactate d
ialysate O-2(-) generation and cytokine synthesis in peritoneal macrop
hages and proliferation of mesothelial cells were inhibited when compa
red to solution containing pyruvate and the control solution. After pr
eincubation with 3.86% glucose containing solutions, all negative effe
cts became even more pronounced in the lactate group whereas after pre
-exposure to pyruvate containing solution the toxic effects were absen
t. These results suggest that the acute toxic effects of commercially
available peritoneal dialysates can be avoided by the use of sodium py
ruvate instead of sodium lactate.