Icodextrin effluent leads to a greater proliferation than glucose effluentof human mesothelial cells studied ex vivo

Objective: To compare the effect of glucose (Glu) and icodextrin (Ico) dial ysate on in vitro culture of mesothelial cells (MC) from peritoneal dialysi s (PD) patients. Design: Prospective, controlled comparative study on the effects of two PD solutions. Setting: A tertiary-care public university hospital. Patients: Sixteen PD patients regularly using Glu dialysate were asked to c ollect an 8-hour dwell peritoneal effluent on 2 different days, with an int erval shorter than 7 days. In the first collection, 2.27% Glu solution and in the last, 7.5% Ico solution was infused. Human MC were isolated from the nocturnal peritoneal effluent bags and grown ex vivo. Main Outcome Measures: Mesothelial cell proliferative capacity ex vivo. Results: Mesothelial cells were present in all patient dialysates except th at of a single patient's Glu dialysate. The number of MC drained was simila r with both solutions. After the initial culture reached confluence, MC wer e identified in 14 and 12 patients receiving Ico and Glu, respectively. How ever, in 1 patient using ice and in 2 using Glu, the MC count at this stage was so low that further subculture could not be performed. Cells from Ice- derived solutions exhibited a higher degree of proliferation than cells fro m Glu-derived solutions. The morphology of MC was also different. Cells fro m drained effluent were typical in 11 patients using Glu solution in contra st with 14 patients using Ice. At confluence, the percentages of typical ap pearance were 50% and 92.9% (p < 0.05) in Glu and Ico respectively. Conclusions: Mesothelial cells taken from icodextrin effluent show a greate r proliferation ex vivo than those taken from glucose effluent.