PYRUVATE ANIONS NEUTRALIZE PERITONEAL DIALYSATE CYTOTOXICITY

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.