EFFECT OF GLUCOSE AND PYRUVATE IN ACIDIC AND NONACIDIC PERITONEAL-DIALYSIS FLUIDS ON LEUKOCYTES CELL FUNCTIONS

A new peritoneal dialysate containing pyruvate anions has been tested for its effects oil cell functions and compared with conventional lact ate and bicarbonate based solutions. The dialysate has a final pH of 5 .4 to 5.6 and is composed of 1.36 to 3.86% glucose-monohydrate, 132 mm ol/liter sodium, 1.75 mmol/liter calcium. 0.75 mmol/liter magnesium. 1 02 mmol/liter chloride and 35 mmol/liter pyruvate. For cytotoxicity te sting peritoneal macrophages and peripheral blood mononuclear cells (P BMC) were exposed to conventional lactate dialysate, pyruvate dialysat e, bicarbonate dialysate and a control medium RPMI 1640 (Biochrom KG, Berlin, Germany), followed by activation with different bacterial stim uli. In addition, the study further investigated the effect of varying glucose concentration in the different dialysates ranging from 0 to 3 .86% and pH changes between 5.2 and 7.4 on the cytotoxicity effect on the selected cells. Mononuclear cells exposed to pyruvate-based dialys ate before stimulation with endotoxin exhibited a tumor necrosis facto r (TNF)-mRNA signal comparable to those of cells exposed to RPMI. In c ontrast, exposure to lactate-based dialysate completely inhibited TNF- mRNA synthesis. In addition, cytokine synthesis in macrophages and PBM Cs after exposure to pyruvate was less inhibited when compared to the corresponding levels measured after exposure to lactate. The chemotact ic response Of polymorphonuclear cells and O-2(-) generation in all te sted cell types after exposure to pyruvate was found not to be inhibit ed, whereas a complete inhibition was observed after exposure to lacta te. The results demonstrate that cytotoxicity effects of peritoneal di alysate on cell lines can be minimized by using a new dialysate formul ation containing pyruvate aninns instead of lactate.