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Topley N. Peritoneal Dialysis Solution Biocompatibility Testing: A Realistic Alternative? Perit Dial Int 2020. [DOI: 10.1177/089686080502500408] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Nicholas Topley
- Institute of Nephrology School of Medicine Cardiff University Cardiff, United Kingdom
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Shimizu H, Ishibashi Y, Kumagai T, Kaname S, Fujita T, Sai K, Nishi T, Mise N, Tagawa H, Sugimoto T. Long-Term Effect of Peritoneal Dialysis Fluid with Neutral pH and Low Glucose Degradation Product Concentration on Peritoneum: A Case Report. Perit Dial Int 2020. [DOI: 10.1177/089686080702700120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Hideki Shimizu
- Division of Total Renal Care Medicine, Mitsui Memorial Hospital Tokyo, Japan
- Department of Nephrology and Endocrinology University of Tokyo School of Medicine, Mitsui Memorial Hospital Tokyo, Japan
| | - Yoshitaka Ishibashi
- Division of Total Renal Care Medicine, Mitsui Memorial Hospital Tokyo, Japan
- Department of Nephrology and Endocrinology University of Tokyo School of Medicine, Mitsui Memorial Hospital Tokyo, Japan
| | - Takanori Kumagai
- Division of Total Renal Care Medicine, Mitsui Memorial Hospital Tokyo, Japan
- Department of Nephrology and Endocrinology University of Tokyo School of Medicine, Mitsui Memorial Hospital Tokyo, Japan
| | - Shinya Kaname
- Division of Total Renal Care Medicine, Mitsui Memorial Hospital Tokyo, Japan
- Department of Nephrology and Endocrinology University of Tokyo School of Medicine, Mitsui Memorial Hospital Tokyo, Japan
| | - Toshiro Fujita
- Department of Nephrology and Endocrinology University of Tokyo School of Medicine, Mitsui Memorial Hospital Tokyo, Japan
| | - Keiko Sai
- Department of Medicine Mitsui Memorial Hospital Tokyo, Japan
| | - Takahiro Nishi
- Department of Medicine Mitsui Memorial Hospital Tokyo, Japan
| | - Naobumi Mise
- Department of Medicine Mitsui Memorial Hospital Tokyo, Japan
| | - Hitoshi Tagawa
- Department of Medicine Mitsui Memorial Hospital Tokyo, Japan
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Grossin N, Wautier MP, Wautier JL, Gane P, Taamma R, Boulanger E. ImprovedIn VitroBiocompatibility of Bicarbonate-Buffered Peritoneal Dialysis Fluid. Perit Dial Int 2020. [DOI: 10.1177/089686080602600610] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BackgroundConventional peritoneal dialysis fluids (PDFs) have been shown to damage the mesothelial layer and are associated with the development of peritoneal fibrosis and neoangiogenesis. New-generation PDFs have therefore been developed with physiological pH and reduced levels of glucose degradation products (GDPs), precursors of advanced glycation end products (AGEs). In this work, we evaluated and compared the improved biocompatibility of two new-generation PDFs (Balance and bicaVera) using mesothelial cell biology; we also compared them to a standard PDF (stay·safe) (all PDFs by Fresenius Medical Care, Fresnes, France).Methodsstay·safe, Balance, and bicaVera were tested for their effect on human peritoneal mesothelial cell (HPMC) viability by measuring cell proliferation and apoptosis, and oncosis induction. The formation of AGEs was evaluated by immunoassay. Transforming growth factor beta-1 and vascular endothelial growth factor (VEGF) were immunoassayed in HPMC supernatants exposed to the above PDFs.ResultsAt 15 g/L glucose concentration, HPMC exposure to bicaVera resulted in higher cell proliferation compared to Balance ( p < 0.001) and stay·safe ( p < 0.001). Compared to the lactate-buffered PDFs (Balance and stay·safe), oncosis was significantly lower in cells exposed to bicaVera ( p < 0.05). bicaVera, containing lower amounts of GDPs, generated less AGE formation ( p < 0.05) and VEGF production ( p < 0.05) than either Balance or stay·safe.ConclusionsNew-generation PDFs with physiological pH and lower GDP levels, especially if bicarbonate-buffered (bicaVera), have fewer in vitro toxic effects on mesothelial cells and may contribute to peritoneal preservation, thus improving long-term treatment of PD patients.
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Affiliation(s)
- Nicolas Grossin
- Institut National de la Transfusion Sanguine UFR Médecine, Paris
| | | | - Jean-Luc Wautier
- Institut National de la Transfusion Sanguine UFR Médecine, Paris
- Université Paris 7-Denis Diderot, UFR Médecine, Paris
| | | | | | - Eric Boulanger
- Institut National de la Transfusion Sanguine UFR Médecine, Paris
- Clinique de Néphrologie, Centre Hospitalier Régional Universitaire, Lille, France
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Kuma A, Tamura M, Ishimatsu N, Harada Y, Izumi H, Miyamoto T, Furuno Y, Nakano Y, Serino R, Otsuji Y. Monocarboxylate Transporter-1 Mediates the Protective Effects of Neutral-pH Bicarbonate/Lactate-Buffered Peritoneal Dialysis Fluid on Cell Viability and Apoptosis. Ther Apher Dial 2016; 21:62-70. [PMID: 27957817 DOI: 10.1111/1744-9987.12476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 05/09/2016] [Accepted: 06/21/2016] [Indexed: 11/28/2022]
Abstract
We investigated the effects of bicarbonate/lactate-buffered peritoneal dialysis fluid (B/L-PDF) and lactate-buffered PDF (L-PDF) on cell viability and apoptosis, focusing on monocarboxylate transporters (MCTs). MCT-1 transports lactate into cells. Cell viability and apoptosis of human peritoneal mesothelial cells (HPMCs) were examined by water-soluble tetrazolium salt-1 and TUNEL assays, respectively. The relative number of viable HPMCs was significantly decreased by L-PDF at 48 h (8.8 ± 0.4%) compared with cells cultured in M199, but not by B/L-PDF (66.7 ± 1.1%). Apoptosis was markedly induced by L-PDF at 48 h (69.3 ± 16.2%), but not by B/L-PDF (2.6 ± 0.3%). Knockdown of MCT-1 by small interfering RNA (siRNA) attenuated the L-PDF-induced reduction of viable cells and increased apoptosis compared with control siRNA, but MCT-4 knockdown had no effect. B/L-PDF had lesser effects on cell viability and apoptosis of HPMCs compared with L-PDF. These results suggest that B/L-PDF biocompatibility occurs by avoiding the induction of apoptosis in HPMCs.
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Affiliation(s)
- Akihiro Kuma
- Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Masahito Tamura
- Kidney Center, University Hospital of Occupational and Environmental Health, Fukuoka, Japan
| | - Nana Ishimatsu
- Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Yoshikazu Harada
- Department of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Hiroto Izumi
- Department of Occupational Pneumology, Institute of Industrial Ecological Science, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Tetsu Miyamoto
- Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Yumi Furuno
- Kidney Center, University Hospital of Occupational and Environmental Health, Fukuoka, Japan
| | - Yoko Nakano
- Kidney Center, University Hospital of Occupational and Environmental Health, Fukuoka, Japan
| | - Ryota Serino
- Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Yutaka Otsuji
- Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
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Abstract
Functional deterioration of the peritoneal membrane in patients on peritoneal dialysis has been described as being the result of a combination of neoangiogenesis and fibrosis. Glucose, glucose degradation products, and the unphysiological pH of the dialysate solution contribute to these changes. Although newer solutions clearly perform better in terms of their biocompatibility in an in vitro setting and in animal models, the benefit of such solutions over older solutions in the clinical setting is so far unproven. The difficulties in showing a benefit of the newer, more biocompatible solutions in the clinical setting can be explained by the fact that other factors also affect the properties of the peritoneal membrane. These factors are often neglected in clinical studies, which results in unnoticed differences in case-mix and blurs the potential impact of the novel solutions. However, many of these factors are modifiable, and attention should be paid to them in clinical practice to maintain the integrity of the peritoneal membrane. This Review focuses on factors that potentially influence the integrity of the peritoneal membrane, other than those associated with the peritoneal dialysis fluid itself.
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Diskin CJ. Lessons From Single Cell Organisms: Insights Into the Antimicrobial and Toxic Effects of Peritoneal Dialysate Bases. Ther Apher Dial 2010; 14:127-35. [DOI: 10.1111/j.1744-9987.2009.00745.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rodrigues AS, Silva S, Bravo F, Oliveira JC, Fonseca I, Cabrita A, Krediet RT. Peritoneal Membrane Evaluation in Routine Clinical Practice. Blood Purif 2008; 25:497-504. [DOI: 10.1159/000113009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2007] [Accepted: 10/19/2007] [Indexed: 11/19/2022]
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Riesenhuber A, Kasper DC, Vargha R, Endemann M, Aufricht C. Quercetin protects human mesothelial cells against exposure to peritoneal dialysis fluid. Pediatr Nephrol 2007; 22:1205-8. [PMID: 17457620 DOI: 10.1007/s00467-007-0484-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Revised: 03/02/2007] [Accepted: 03/12/2007] [Indexed: 10/23/2022]
Abstract
During peritoneal dialysis, mesothelial cells have been shown to undergo severe damage due to continuous exposure to peritoneal dialysis fluid (PDF) with cytotoxic physicochemical properties. In this study, we investigated the cytoprotective role of the bioflavonoid Quercetin in the in vitro model of peritoneal dialysis. Immortalized human mesothelial cells (Met5A) were exposed either to regular growth medium or to standard acidic lactate-buffered PDF (Dianeal PD4) or to a more biocompatible lactate-bicarbonate-buffered PDF (Physioneal 40). Parallel cell cultures were supplemented with 200 microM Quercetin. Cytotoxicity was assessed qualitatively by morphologic assessment and quantitatively by the release of cytoplasmic lactate dehydrogenase and fluorescence-activated cell sorting (FACS). PDF exposure with bioincompatible Dianeal PD4 resulted in severe disruption of cell cultures and in significantly increased lactate dehydrogenase (LDH) release (p=0.0007 vs. control). Addition of 200 microM Quercetin significantly decreased the LDH release (p=0.04 vs. "pure" Dianeal PD4 exposure), comparable to control exposure and to more biocompatible Physioneal 40 exposure (p=0.37) and resulted in marked preservation of cell culture monolayers and cellular viability as assessed by FACS. Introduction of cytoprotective agents such as Quercetin may represent an alternate approach to protect mesothelial cells from cytotoxicity of frequently used PDFs, comparably effective to the introduction of novel, more biocompatible, PDFs.
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Affiliation(s)
- Andrea Riesenhuber
- Department of Pediatrics, Medical University of Vienna, Kinderdialyse, Universitaetsklinik fuer Kinder-und Jugendheilkunde, Waehringer Guertel 18-20, 1090, Wien, Austria
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Ahmad S, Sehmi JS, Ahmad-Zakhi KH, Clemenger M, Levy JB, Brown EA. Impact of new dialysis solutions on peritonitis rates. Kidney Int 2007:S63-6. [PMID: 17080113 DOI: 10.1038/sj.ki.5001917] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Peritonitis remains a major cause of morbidity among patients on peritoneal dialysis (PD), yet there is little information about the effect of new biocompatible dialysis solutions on peritonitis rates and treatment. In our unit, information on each peritonitis episode is prospectively collected. Since 2003, bicarbonate/lactate dialysate has been gradually introduced for new patients and for patients experiencing abdominal pain with conventional lactate solutions. From 2002 to 2005, data from 121 episodes of peritonitis (71 automated PD and 50 continuous ambulatory PD) were analyzed; 107 episodes occurred in patients using standard lactate dialysate and 14 episodes in patients using bicarbonate/lactate solution. Patients using bicarbonate/lactate had a significantly lower peritonitis rate of 1 per 52.5 patient-months compared to those using standard lactate dialysate (1 per 26.9 patient-months) (P=0.0179). Response to treatment, however, was not affected by the type of dialysate; cure rates (71.4 and 69.1%, respectively) and recurrence rates (21.4 and 15.8%, respectively) were not significantly different. Catheter removal was required in three (21.4%) patients using bicarbonate/lactate and 23 (22.4%) patients using lactate solution. Use of biocompatible dialysate appears to reduce the peritonitis rate by 50%, although this has to be confirmed in a randomized study. The type of dialysate, on the other hand, does not affect response to treatment.
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Affiliation(s)
- S Ahmad
- Department of Renal Medicine, Imperial College London, Charing Cross Hospital, London, UK.
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