Comparison of the biocompatibility of phosphate-buffered saline alone, phosphate-buffered saline supplemented with glucose, and dianeal 3.86%

◆ Objective: We compared the effects of intraperitoneal infusion of phosphate-buffered saline (PBS, pH 7.4), of PBS supplemented with 3.86% glucose (G), and of standard dialysis solution [Dianeal 3.86%: Baxter Healthcare Corporation, Deerfield, IL, U.S.A. (D)] on intraperitoneal inflammation in dialyzed rats. ◆ Methods: After catheter implantation, rats were infused on day 1 with PBS, on day 3 with PBS+G, on day 5 with D, and on day 7 again with PBS (PBS-2). After a 4-hour dwell, dialysate samples were collected and analyzed. ◆ Results: All dialysate parameters studied [dialysate cell count, neutrophil:macrophage ratio (Ne:Ma), and total protein], except tumor necrosis factor alpha (TNFα), were comparable during both PBS infusions. During dialysis with PBS+G, the inflammatory response was suppressed as compared with the first dialysis with PBS (cell count, p<0.001; Ne:Ma, p<0.05; TNFα, p<0.001; total protein, p<0.001). During dialysis with D, peritoneal inflammatory parameters were further suppressed (cell count, p<0.001 vs PBS and p<0.01 vs PBS+G; Ne:Ma, p<0.001 vs PBS and p<0.05 vs PBS+G; TNFα, p<0.001 vs PBS and p<0.001 vs PBS+G; total protein, p<0.001 vs PBS and p<0.01 vs PBS+G). ◆ Conclusions: Hypertonicity of the dialysis fluid suppresses intraperitoneal inflammatory parameters in rats. The suppression was even more severe when Dianeal 3.86% was used. That finding could be due to the low pH and presence of GDPs in the fluid.