A. Mahiout et al., EFFECT OF GLUCOSE AND PYRUVATE IN ACIDIC AND NONACIDIC PERITONEAL-DIALYSIS FLUIDS ON LEUKOCYTES CELL FUNCTIONS, Kidney international, 51(3), 1997, pp. 860-867
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.