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Perit Dial Int 26(6): 664-670 2006
© 2006 International Society for Peritoneal Dialysis
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Clinical

IMPROVED IN VITRO BIOCOMPATIBILITY OF BICARBONATE-BUFFERED PERITONEAL DIALYSIS FLUID

Nicolas Grossin1, Marie-Paule Wautier2, Jean-Luc Wautier1,3, Pierre Gane2, Redouane Taamma4 and Eric Boulanger1,5

1 Institut National de la Transfusion Sanguine; 2 INSERM, U665;3 Université Paris 7-Denis Diderot, UFR Médecine, Paris; 4 Fresenius Medical Care, Fresnes; 5 Clinique de Néphrologie, Centre Hospitalier Régional Universitaire, Lille, France

Correspondence to: E. Boulanger, Laboratoire de Biologie Vasculaire et Cellulaire, Institut National de la Transfusion Sanguine, 6 Rue A. Cabanel, 75739 Paris, Cedex 15, France.
dreboulanger{at}hotmail.com

{diamondsuit} Background: Conventional 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).

{diamondsuit} Methods: stay·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.

{diamondsuit} Results: At 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.

{diamondsuit} Conclusions: New-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.

KEY WORDS: Glycoxidation; biocompatibility; mesothelial cell.

Received 21 December 2005; accepted 22 April 2006.






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