BICARBONATE-BASED DIALYSIS SOLUTION PRESERVES GRANULOCYTE FUNCTIONS

Objective: Intraperitoneal phagocytes play an important role in local defense in preventing continuous ambulatory peritoneal dialysis (CAPD) peritonitis. This study therefore investigates the effect of the conv entional lactate-based dialysis solution-pH 5.2 (LBDS-pH 5.2) and a bi carbonate-based dialysis solution (BBDS) on various cell functions. De sign: We studied C5a-induced actin polymerization (AP) as a measure of the cytoskeletal alteration, phagocytosis of zymosan particles, and c hemotaxis in neutrophils incubated in either LBDS-pH 5.2, LBDS-pH 7.4, or BBDS-pH 7.4, comparing the data with cells treated with phosphate- buffered saline-pH 7.4 (PBS-pH 7.4) as a control. Subjects: Polymorpho nuclear neutrophils (PMNs) were isolated from the blood of healthy don ors and incubated with dialysis solution prior to the experiment. Resu lts: C5a-induced AP was dramatically inhibited in PMNs incubated in LB DS-pH 5.2, paralleled by a complete inhibition of phagocytosis and C5a -induced chemotaxis. In comparison, BBDS improved AP to values above t he control and also nearly normalized phagocytosis. Chemotaxis markedl y improved in cells treated with the low glucose-containing BBDS (Bic 20), but was still inhibited in PMNs incubated in the BBDS containing high glucose concentrations (Bic 30). Conclusion: In comparison with c onventional lactate-based dialysis solution-pH 5.2, bicarbonate-based dialysis solution at low osmolality better preserves neutrophil functi ons that involve the cytoskeleton.