TY - JOUR
T1 - Bicarbonate/lactate dialysis solution improves in vivo function of peritoneal host defense in rats
AU - Pawlaczyk, Krzysztof
AU - Kuzlan-Pawlaczyk, Malgorzata
AU - Wieczorowska-Tobis, Katarzyna
AU - Polubinska, Alicja
AU - Wisniewska, Justyna
AU - Faict, Dirk
AU - Holmes, Cliff J.
AU - Breborowicz, Andrzej
PY - 1999
Y1 - 1999
N2 - Objective: To assess the in vivo peritoneal inflammatory reaction in rats dialyzed with neutral, bicarbonate-lactate-buffered dialysis fluid. Methods: Chronic peritoneal dialysis was performed for 4 weeks in Wistar rats with two solutions: (1) 40 mmol/L lactate-buffered fluid, pH 5.2, with a glucose concentration of 2.27 g/dl (Lac); and, (2) 15 mmol/L lactate and 25 mmol/L bicarbonate-buffered fluid, pH 7.0-7.5, with a glucose concentration of 2.27 g/dL (Bic-Lac). After 4 weeks, two peritoneal equilibration tests (PET 1 and PET 2) were performed in all animals with each respective solution. PET 1 was done with test solutions alone, whereas, on a subsequent day, PET 2 was performed with test solutions supplemented with endotoxin [lipopolysaccharide (LPS)] to induce peritonitis. Results: During PET 1 no consistent differences were detected in peritoneal permeability between the Lac and Bic-Lac groups. Total dialysate cell count in the Bic-Lac animals was lower than in rats treated with Lac fluid: that is, at 8 hours, the respective counts were 1858 ± 524 cells/μL versus 2785 ± 1162 cells/μL (p < 0.01). Dialysate from animals dialyzed with Bic-Lac contained more macrophages (at 4 hours: 53.6% ± 35.8% versus 35.8% ± 8.8%, p < 0.001) and fewer neutrophils (at 4 hours: 3.6% ± 1.8% versus 15.4% ± 6.1%, p < 0.001) as compared to those dialyzed with the Lac solution. Concentration of nitrites in 8-hour dwell dialysate samples from Bic-Lac rats was lower than that in the Lac group (0.98 ± 0.28 μmol/ml versus 2.32 ± 0.87 μmol/mL, p < 0.002), but cytokine levels in the dialysates were comparable. During PET 2, the increase in peritoneal permeability resulting from the LPS-induced inflammatory response was similar for both test solutions. Dialysate cell count was higher in the Lac group versus the Bic-Lac group (at 8 hours: 8789 ± 4862 cells/μL versus 3961 ± 581 cells/μL, p < 0.001), contained more neutrophils (at 8 hours: 80.0% ± 11.3% versus 54.8% ± 4.4%, p < 0.001) and fewer macrophages (at 8 hours: 6.8% ± 5.6% versus 21.2% ± 3.3%, p < 0.05). During peritonitis, we found a higher overall dialysate concentration of both tumor necrosis factor (TNFα: +53%, p < 0.05) and of interferon gamma (IFN-γ: +303%, p < 0.02), in the Bic-Lac group than in the Lac group. Conclusions: A lower dialysate cell count, higher percentage of macrophages, and lower percentage of neutrophils in dialysate suggest that Bic-Lac fluid induces a diminished nonspecific inflammatory response of the peritoneal cavity during dialysis. However, after in vivo stimulation, peritoneal cells from animals dialyzed with Bic-Lac solution possess an augmented ability to produce inflammatory cytokines.
AB - Objective: To assess the in vivo peritoneal inflammatory reaction in rats dialyzed with neutral, bicarbonate-lactate-buffered dialysis fluid. Methods: Chronic peritoneal dialysis was performed for 4 weeks in Wistar rats with two solutions: (1) 40 mmol/L lactate-buffered fluid, pH 5.2, with a glucose concentration of 2.27 g/dl (Lac); and, (2) 15 mmol/L lactate and 25 mmol/L bicarbonate-buffered fluid, pH 7.0-7.5, with a glucose concentration of 2.27 g/dL (Bic-Lac). After 4 weeks, two peritoneal equilibration tests (PET 1 and PET 2) were performed in all animals with each respective solution. PET 1 was done with test solutions alone, whereas, on a subsequent day, PET 2 was performed with test solutions supplemented with endotoxin [lipopolysaccharide (LPS)] to induce peritonitis. Results: During PET 1 no consistent differences were detected in peritoneal permeability between the Lac and Bic-Lac groups. Total dialysate cell count in the Bic-Lac animals was lower than in rats treated with Lac fluid: that is, at 8 hours, the respective counts were 1858 ± 524 cells/μL versus 2785 ± 1162 cells/μL (p < 0.01). Dialysate from animals dialyzed with Bic-Lac contained more macrophages (at 4 hours: 53.6% ± 35.8% versus 35.8% ± 8.8%, p < 0.001) and fewer neutrophils (at 4 hours: 3.6% ± 1.8% versus 15.4% ± 6.1%, p < 0.001) as compared to those dialyzed with the Lac solution. Concentration of nitrites in 8-hour dwell dialysate samples from Bic-Lac rats was lower than that in the Lac group (0.98 ± 0.28 μmol/ml versus 2.32 ± 0.87 μmol/mL, p < 0.002), but cytokine levels in the dialysates were comparable. During PET 2, the increase in peritoneal permeability resulting from the LPS-induced inflammatory response was similar for both test solutions. Dialysate cell count was higher in the Lac group versus the Bic-Lac group (at 8 hours: 8789 ± 4862 cells/μL versus 3961 ± 581 cells/μL, p < 0.001), contained more neutrophils (at 8 hours: 80.0% ± 11.3% versus 54.8% ± 4.4%, p < 0.001) and fewer macrophages (at 8 hours: 6.8% ± 5.6% versus 21.2% ± 3.3%, p < 0.05). During peritonitis, we found a higher overall dialysate concentration of both tumor necrosis factor (TNFα: +53%, p < 0.05) and of interferon gamma (IFN-γ: +303%, p < 0.02), in the Bic-Lac group than in the Lac group. Conclusions: A lower dialysate cell count, higher percentage of macrophages, and lower percentage of neutrophils in dialysate suggest that Bic-Lac fluid induces a diminished nonspecific inflammatory response of the peritoneal cavity during dialysis. However, after in vivo stimulation, peritoneal cells from animals dialyzed with Bic-Lac solution possess an augmented ability to produce inflammatory cytokines.
KW - Bicarbonate
KW - Cytokines
KW - Inflammation
KW - Peritoneal permeability
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U2 - 10.1177/089686089901902s60
DO - 10.1177/089686089901902s60
M3 - Article
C2 - 10406549
AN - SCOPUS:0033397285
SN - 0896-8608
VL - 19
SP - S370-S377
JO - Peritoneal Dialysis International
JF - Peritoneal Dialysis International
IS - SUPPL. 2
ER -