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Jonasson P, Braide M. Acute in Vivotoxicity of Heat-Sterilized Glucose Peritoneal Dialysis Fluids to Rat Peritoneal Macrophages. Perit Dial Int 2020. [DOI: 10.1177/089686089801800405] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate the in vivo effects of heat-sterilized peritoneal dialysis (PD) fluids on the respiratory burst response of rat peritoneal leukocytes. Design Rats were exposed to intraperitoneal injections of a laboratory-made PD fluid that was either heat-sterilized (HPD) or filtered (F-PD). Control groups of animals were given Hank's buffer (HBSS) or saline (NaCI). Leukocytes were harvested by intraperitoneal lavage at different times in different animals and analyzed with respect to cell numbers, differential counts, and production of superoxide (chemiluminescence) in response to opsonized zymosan. The chemiluminescence responses of the macrophage and the neutrophil populations, respectively, were obtained by curve-fitting techniques from the responses of the mixed populations. Results All fluids induced a recruitment of neutrophils, the PD fluids causing a cell number increase that was more transient than that caused by NaCI and HBSS. Macrophage numbers were only slightly influenced, but were generally higher after NaCI and HBSS injections than after PD fluid injections. The H-PD exposure induced a significant inhibition of the macrophage chemiluminescence response after 2 and 12 hours, compared with the exposure to F-PD. The neutrophil chemiluminescence response was not significantly affected. Conclusion The toxins produced by heat-sterilization of glucose-containing PD fluids inhibit in vivo the respiratory burst response of peritoneal macrophages.
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Affiliation(s)
- Peter Jonasson
- Department of Anatomy and Cell Biology, Göteborg University, Göteborg, Sweden
| | - Magnus Braide
- Department of Anatomy and Cell Biology, Göteborg University, Göteborg, Sweden
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2
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Van Biesen W, Faict D, Boer W, Lameire N. Further Animal and Human Experience with a 0.6% Amino Acid/1.4% Glycerol Peritoneal Dialysis Solution. Perit Dial Int 2020. [DOI: 10.1177/089686089701702s11] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | | | - Walther Boer
- Renal Division, University Hospital, Utrecht, the Netherlands
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3
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Jorres A, Williams JD, Topley N. Peritoneal Dialysis Solution Biocompatibility: Inhibitory Mechanisms and Recent Studies with Bicarbonate-Buffered Solutions. Perit Dial Int 2020. [DOI: 10.1177/089686089701702s08] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Achim Jorres
- Abteilung fur Innere Medizin mit Schwerpunkt Nephrologie und Internistische Intensivmedizin, Virchow-Klinikum, Humboldt Universitat zu Berlin, Germany
| | - John D. Williams
- Institute of Nephrology, University of Wales College of Medicine, Cardiff Royal Infirmary, Cardiff, UK
| | - Nicholas Topley
- Institute of Nephrology, University of Wales College of Medicine, Cardiff Royal Infirmary, Cardiff, UK
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4
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Topley N. What is the Ideal Technique for Testing the Biocompatibility of Peritoneal Dialysis Solutions? Perit Dial Int 2020. [DOI: 10.1177/089686089501500306] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Nicholas Topley
- Institute of Nephrology University of Wales College of Medicine Cardiff Royal Infirmary Cardiff, Wales, United Kingdom
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5
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Topley N. What is the Ideal Technique for Testing the Biocompatibility of Peritoneal Dialysis Solutions? Perit Dial Int 2020. [DOI: 10.1177/089686089501507s15] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Nicholas Topley
- Institute of Nephrology, University of Wales College of Medicine, Cardiff Royal Infirmary, Cardiff, Wales, United Kingdom
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6
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Affiliation(s)
- Achim Jörres
- Nephrologie, Universitätsklinikum Rudolf Virchow, Berlin-Charlottenburg, Germany
| | - Gerhard M. Gahl
- Nephrologie, Universitätsklinikum Rudolf Virchow, Berlin-Charlottenburg, Germany
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7
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8
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Müller-Wiefel DE. Treatment of Peritonitis in Pediatric Continuous Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686089901902s74] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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9
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Jörres A, Gahl GM, Frei U. In Vitro Studies on the Effect of Dialysis Solutions on Peritoneal Leukocytes. Perit Dial Int 2020. [DOI: 10.1177/089686089501507s06] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Achim Jörres
- Abteilung für Innere Medizin mit Schwerpunkt Nephrologie und Internistische Intensivmedizin, Virchow-Klinikum, Berlin, Germany
| | - Gerhard M. Gahl
- Abteilung für Innere Medizin mit Schwerpunkt Nephrologie und Internistische Intensivmedizin, Virchow-Klinikum, Berlin, Germany
| | - Ulrich Frei
- Abteilung für Innere Medizin mit Schwerpunkt Nephrologie und Internistische Intensivmedizin, Virchow-Klinikum, Berlin, Germany
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10
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Edefonti A, Consalvo G, Pappalettera M. Infectious Complications in Pediatric Patients Treated with Chronic Peritoneal Dialysis (Cpd). Perit Dial Int 2020. [DOI: 10.1177/089686089601601s111] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Alberto Edefonti
- Department of Pediatrics l’, University of Milano, Milano, Italy
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11
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Topley N. What is the Ideal Technique for Testing the Biocompatibility of Peritoneal Dialysis Solutions? Perit Dial Int 2020. [DOI: 10.1177/089686089501506s16] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Nicholas Topley
- Institute of Nephrology University of Wales College of Medicine Cardiff Royal Infirmary Cardiff, Wales, United Kingdom
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12
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Warady BA, Schaefer F, Holloway M, Alexander S, Kandert M, Piraino B, Salusky I, Tranæus A, Divino J, Honda M, Mujais S, Verrina E. Consensus Guidelines for the Treatment of Peritonitis in Pediatric Patients Receiving Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686080002000607] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Beth Piraino
- University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A
| | | | | | | | | | - Salim Mujais
- Renal Division, Baxter Healthcare Corporation, Deerfield, Illinois, U.S.A
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13
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Morphological characteristics in peritoneum in patients with neutral peritoneal dialysis solution. J Artif Organs 2015; 18:243-50. [DOI: 10.1007/s10047-015-0822-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 02/04/2015] [Indexed: 10/24/2022]
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Warady BA, Bakkaloglu S, Newland J, Cantwell M, Verrina E, Neu A, Chadha V, Yap HK, Schaefer F. Consensus guidelines for the prevention and treatment of catheter-related infections and peritonitis in pediatric patients receiving peritoneal dialysis: 2012 update. Perit Dial Int 2013; 32 Suppl 2:S32-86. [PMID: 22851742 DOI: 10.3747/pdi.2011.00091] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Bradley A Warady
- Division of Pediatric Nephrology, Children's Mercy Hospitals and Clinics, Kansas City, Missouri 64108, USA.
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Chadha V, Schaefer FS, Warady BA. Dialysis-associated peritonitis in children. Pediatr Nephrol 2010; 25:425-40. [PMID: 19190935 PMCID: PMC2810362 DOI: 10.1007/s00467-008-1113-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Revised: 11/18/2008] [Accepted: 12/09/2008] [Indexed: 01/06/2023]
Abstract
Peritonitis remains a frequent complication of peritoneal dialysis in children and is the most common reason for technique failure. The microbiology is characterized by a predominance of Gram-positive organisms, with fungi responsible for less than 5% of episodes. Data collected by the International Pediatric Peritonitis Registry have revealed a worldwide variation in the bacterial etiology of peritonitis, as well as in the rate of culture-negative peritonitis. Risk factors for infection include young age, the absence of prophylactic antibiotics at catheter placement, spiking of dialysis bags, and the presence of a catheter exit-site or tunnel infection. Clinical symptoms at presentation are somewhat organism specific and can be objectively assessed with a Disease Severity Score. Whereas recommendations for empiric antibiotic therapy in children have been published by the International Society of Peritoneal Dialysis, epidemiologic data and antibiotic susceptibility data suggest that it may be desirable to take the patient- and center-specific history of microorganisms and their sensitivity patterns into account when prescribing initial therapy. The vast majority of patients are treated successfully and continue peritoneal dialysis, with the poorest outcome noted in patients with peritonitis secondary to Gram-negative organisms or fungi and in those with a relapsing infection.
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Affiliation(s)
- Vimal Chadha
- Department of Pediatrics, Section of Nephrology, Virginia Commonwealth University Medical Center, Richmond, VA USA
| | - Franz S. Schaefer
- Center for Pediatric and Adolescent Medicine, Section of Pediatric Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Bradley A. Warady
- Department of Pediatrics, Section of Nephrology, The Children’s Mercy Hospital, Kansas City, MO USA
- University of Missouri–Kansas City School of Medicine, The Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108 USA
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Cytotoxicity of Mononuclear Cells as Induced by Peritoneal Dialysis Fluids: Insight into Mechanisms that Regulate Osmotic Stress-Related Apoptosis. Perit Dial Int 2008. [DOI: 10.1177/089686080802800619] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective High glucose content of peritoneal dialysis fluids (PDFs) has been shown to contribute to loss of peritoneal function during long-term peritoneal dialysis. However, hyperosmolality and hypertonicity of PDF are usually seen as similar stress events inducing osmotic stress-induced programmed cell death. In this study, we examined the impact of various osmotic agents on apoptosis induced by hyperosmolar PDFs, focusing on the mechanisms underlying the lethal effects of PDFs on peripheral blood mono-nuclear cells (PBMCs). Methods We assessed apoptosis and necrosis by annexin V–propidium iodide (PI) labeling, and caspase-3 activity by fluorescence assay. F-actin remodeling was measured using fluorescent phalloidin labeling. Results Hyperosmolality does not cause the cytotoxicity observed with PDF, but exposure to agents incapable of permeating cell membranes results in a significant increase in the percentage of apoptotic PBMCs by annexin V–PI labeling, which is confirmed by the increase in caspase-3 activity. Interestingly, inhibition of caspase-3 by Z-VAD-FMK did not suppress apoptosis. Extracellular hypertonicity produced polymerization of filamentous actin and cell shrinkage, which displayed similar time courses. Cell shrinkage was blocked by cytochalasin D, indicating an active role for actin cytoskeleton in hypertonicity-induced cell shrinkage. F-actin polymerization was related to an increase in intra-cellular ionic strength. Finally, we excluded a direct role for actin remodeling in osmotic stress-induced programmed cell death. Conclusions Exposure to osmolytes that cannot penetrate cell membranes results in a hypertonicity-induced apoptosis that cannot be blocked by the broad-spectrum caspase inhibitor Z-VAD-FMK. In addition, extracellular hypertonicity induced by impermeant solutes produces F-actin polymerization through an increase in intracellular ionic strength. The remodeling of the cytoskeleton does not modulate apoptosis but participates in cell shrinkage.
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Van Biesen W, Veys N, Vanholder R, Lameire N. New concepts in peritoneal dialysis: new wine in old barrels? Artif Organs 2003; 27:398-405. [PMID: 12752197 DOI: 10.1046/j.1525-1594.2003.00965.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Van Biesen W, Vanholder R, Lameire N. Recent developments in osmotic agents for peritoneal dialysis. ADVANCES IN RENAL REPLACEMENT THERAPY 1998; 5:218-31. [PMID: 9686633 DOI: 10.1016/s1073-4449(98)70035-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although glucose is still the most widely used osmotic agent for peritoneal dialysis, it has several disadvantages that challenge its long-term use. During the past years several nonglucose molecules have been tested as osmotic agents for peritoneal dialysis. Most of these molecules have some advantages over glucose, but they also have drawbacks. Every new agent should be carefully tested for performance and long-term safety. In the following review, alternative osmotic agents are discussed, including their potential indications and drawbacks. Major issues include the improvement of biocompatibility and preservation of peritoneal membrane integrity by using dialysate with more physiologic pH, the effect on nutritional status by using dialysate with amino acids, and maintenance of peritoneal ultrafiltration in the long-term by using dialysate with polyglucose. It is believed that in the near future, mixtures of osmotic agents will become most appropriate to obtain the best performance.
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Affiliation(s)
- W Van Biesen
- Department of Internal Medicine, University Hospital, Gent, Belgium
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