REDUCED GLUCOSE DEGRADATION PRODUCTS IN BICARBONATE LACTATE-BUFFERED PERITONEAL-DIALYSIS SOLUTIONS PRODUCED IN 2-CHAMBERED BAGS/

Objectives: The aims of the current study were: (1) to determine the e ffects of peritoneal dialysis (PD) solutions at different glucose conc entrations on the growth of cultured cells; (2) to determine whether a bicarbonate/lactate-based solution, as a result of the configuration of its components during heat sterilization in a two-chambered bag, wa s lower in glucose degradation products than a corresponding lactate-b ased PD solution; and (3) to determine whether lower glucose degradati on corresponded to a decreased inhibition of cell growth. Design: Grow th inhibition of cells exposed to lactate-based Po solutions at three different glucose concentrations was determined. Bicarbonate/lactate-b ased and lactate-based solutions at high glucose concentration (3.86%) were further analyzed for presence of glucose degradation products an d inhibition of cell growth. Methods: Cell growth was determined by ne utral red uptake, measured by optical density at 540 nm. Glucose degra dation to acetaldehyde or fructose was determined by gas chromatograph y-mass spectroscopy and highperformance liquid chromatography. Results : Only 3.86% glucose lactate-based PD solution caused significant inhi bition of cell growth (p < 0.05). The heat-sterilized, bicarbonate/lac tate-based solution (3.86% glucose) had lower levels of fructose and a cetaldehyde than a conventional heat-sterilized, lactate-based solutio n with the same glucose concentration. Growth of cultured cells expose d to the bicarbonate/lactate-based solution was significantly improved (p < 0.05) over growth in the conventional solution. Conclusions:The bicarbonate/lactate-based solutions, manufactured and heat-sterilized in two-chambered bags, were lower in glucose degradation products than the corresponding lactate-based PD solutions, and demonstrated improv ed in vitro biocompatibility as measured by the growth of cultured cel ls.