CELL-FUNCTION AND VIABILITY IN GLUCOSE POLYMER PERITONEAL-DIALYSIS FLUIDS

Objective: To investigate the biocompatibility profile of a new perito neal dialysis fluid containing glucose polymer (GPF). Design: Viabilit y and function of peripheral neutrophils (PMN) from healthy donors and cultured human peritoneal mesothelial cells were assessed in vitro af ter exposure to dialysis fluids. Phagocytosis, leukotriene B4 synthesi s, and respiratory burst activation were measured following stimulatio n with serum-treated zymosan (STZ) or opsonized Staphylococcus epiderm idis (S. epidermidis). Bacterial growth in the fluids was also investi gated. In vivo pH equilibration of GPF and subsequent respiratory burs tactivation following incubation in spent dialysate were studied. Resu lts: For all the host defense parameters measured, commercial dialysis fluids (Dianeal; 1.36% and 3.86% glucose) and GPF (pH 5.2) were signi ficantly more inhibitory than the control buffer (pH 7.3). Mesothelial cell viability was reduced by all the fluids tested irrespective of p H. Glucose polymer fluid was significantly more inhibitory than Dianea l 1.36% for STZ phagocytosis and respiratory burst activation. In cont rast, it was less suppressive than Dianeal 3.86% for LTB4 synthesis. F or all parameters tested, except LTB4 generation, there was a marked e ffect of pH, with GPF being significantly more inhibitory at pH 5.2 th an at pH 7.3. None of the fluids tested supported the growth of S. epi dermidis, although the viable counts in GPF were significantly higher than in Dianeal. Fluid inhibition of PMN respiratory burst activation and cytotoxicity were reduced in a time-dependent manner following inc reasing dwell time in vivo. Conclusions: GPF does not appear to be sig nificantly different from Dianeal as far as host defense parameters ar e concerned. However, the cell viability and bacterial survival data s uggest some possibly negative aspects of this fluid formation.