CHANGES IN BIOCOMPATIBILITY OF DIALYSIS FLUID DURING ITS DWELL IN THEPERITONEAL-CAVITY

Objective: To evaluate the changes in biocompatibility of peritoneal d ialysis solutions during intraperitoneal dwell. Design: We studied the effect of the drained dialysates at time 0 and after 30, 60, 120, 240 , and 360 minutes of intraperitoneal dwell on the growth of peritoneal mesothelial cells and fibroblasts and the synthesis of proteins by th ese cells. On one day the patients were dialyzed with glucose-based Di aneal and on alternate days with an amino acid-containing solution bas ed on Travasol. Patients: Dialysates were collected from 4 patients du ring continuous ambulatory peritoneal dialysis (CAPD) training. Result s: Unused dialysis solutions containing glucose or amino acids inhibit growth of mesothelial cells and fibroblasts. Dialysates obtained afte r 30 or 60 minutes of intraperitoneal dwell support the growth of thes e cells in away similar to 10% fetal calf serum, but dialysates draine d after a longer dwell of 120 - 360 minutes had a stronger effect on g rowth of these cells than did serum. All glucose-based dialysates stim ulate the synthesis of collagen in mesothelial cells, whereas they red uce the synthesis of non-collagen proteins. All glucose-based dialysat es reduce the synthesis of collagen and noncollagen proteins in fibrob lasts compared with the production of these proteins in the presence o f serum. Conclusion: Changes in the properties of the dialysis solutio ns during their intraperitoneal dwells do not seem to increase their b iocompatibility. Indeed, excessive mitogenic effect and the stimulatio n of collagen synthesis of the dialysates may induce pathological chan ges in the peritoneum.