Peritoneal dialysis with solutions low in glucose degradation products is associated with improved biocompatibility profile towards peritoneal mesothelail cells

Janusz Witowski, Katarzyna Korybalska, Krzysztof Ksiazek, Justyna Wiśniewska-Elnur, Achim Jörres, Christina Lage, Thomas P. Schaub, Jutta Passlick-Deetjen, Andrzej Breborowicz, Alicja Grzegorzewska, Andrzej Ksiazek, Tomasz Liberek, Monika Lichodziejewska-Niemierko, Maria Majdan, Bolesław Rutkowski, Tomasz Stompór, Władysław Sułowicz

Research output: Contribution to journalArticle

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Abstract

Background. In vitro experiments point to a better biocompatibility profile of new pH-neutral peritoneal dialysis fluids (PDFs) containing low levels of glucose degradation products (GDPs). The present study examines the impact on human peritoneal mesothelial cells (HPMCs) of equilibrated dialysates obtained during dialysis with either conventional or new PDFs. Methods. Peritoneal dialysate was collected from 17 patients participating in a randomized, controlled, cross-over trial comparing a pH-neutral low-GDP solution (Balance) to a conventional solution (S-PDF). All patients were treated sequentially for 3 months with both PDFs. At the end of each treatment phase, peritoneal effluent was drained after a timed 10 h dwell. Samples of dialysate were then mixed with standard culture medium and added to in vitro cultures of HPMCs from healthy donors. Cells were assessed for proliferation, viability and cytokine release. Results. Proliferation and viability of HPMCs were better preserved in the presence of effluent obtained during dialysis with Balance (P < 0.046 and P < 0.035, respectively). The proliferative response of HPMCs correlated with the concentration of fibronectin in dialysates (P=0.0024). Effluent drained following a 3 month dialysis with Balance contained significantly increased levels of fibronectin (P=0.004) and CA125 antigen (P = 0.0004) compared with S-PDF. There was no significant difference in constitutive and stimulated cytokine (IL-6, MCP-1, VEGF) synthesis by HPMCs treated with either Balance- or S-PDF-derived effluents. Conclusions. These results suggest that therapy with new pH-neutral low-GDP solutions contribute to an intraperitoneal milieu that improves mesothelial cell proliferation and viability. It may positively impact on the preservation of the peritoneal membrane integrity during long-term dialysis.

Original languageEnglish (US)
Pages (from-to)917-924
Number of pages8
JournalNephrology Dialysis Transplantation
Volume19
Issue number4
DOIs
StatePublished - Apr 2004
Externally publishedYes

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Ascitic Fluid
Dialysis Solutions
Peritoneal Dialysis
Glucose
Dialysis
Fibronectins
CA-125 Antigen
Cytokines
Cross-Over Studies
Vascular Endothelial Growth Factor A
Culture Media
Interleukin-6
Cell Survival
Cell Proliferation
Tissue Donors
Membranes
Therapeutics

Keywords

  • Biocompatibility
  • Glucose degradation products
  • Peritoneal dialysis
  • Peritoneal mesothelial cells

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Peritoneal dialysis with solutions low in glucose degradation products is associated with improved biocompatibility profile towards peritoneal mesothelail cells. / Witowski, Janusz; Korybalska, Katarzyna; Ksiazek, Krzysztof; Wiśniewska-Elnur, Justyna; Jörres, Achim; Lage, Christina; Schaub, Thomas P.; Passlick-Deetjen, Jutta; Breborowicz, Andrzej; Grzegorzewska, Alicja; Ksiazek, Andrzej; Liberek, Tomasz; Lichodziejewska-Niemierko, Monika; Majdan, Maria; Rutkowski, Bolesław; Stompór, Tomasz; Sułowicz, Władysław.

In: Nephrology Dialysis Transplantation, Vol. 19, No. 4, 04.2004, p. 917-924.

Research output: Contribution to journalArticle

Witowski, J, Korybalska, K, Ksiazek, K, Wiśniewska-Elnur, J, Jörres, A, Lage, C, Schaub, TP, Passlick-Deetjen, J, Breborowicz, A, Grzegorzewska, A, Ksiazek, A, Liberek, T, Lichodziejewska-Niemierko, M, Majdan, M, Rutkowski, B, Stompór, T & Sułowicz, W 2004, 'Peritoneal dialysis with solutions low in glucose degradation products is associated with improved biocompatibility profile towards peritoneal mesothelail cells', Nephrology Dialysis Transplantation, vol. 19, no. 4, pp. 917-924. https://doi.org/10.1093/ndt/gfh013
Witowski, Janusz ; Korybalska, Katarzyna ; Ksiazek, Krzysztof ; Wiśniewska-Elnur, Justyna ; Jörres, Achim ; Lage, Christina ; Schaub, Thomas P. ; Passlick-Deetjen, Jutta ; Breborowicz, Andrzej ; Grzegorzewska, Alicja ; Ksiazek, Andrzej ; Liberek, Tomasz ; Lichodziejewska-Niemierko, Monika ; Majdan, Maria ; Rutkowski, Bolesław ; Stompór, Tomasz ; Sułowicz, Władysław. / Peritoneal dialysis with solutions low in glucose degradation products is associated with improved biocompatibility profile towards peritoneal mesothelail cells. In: Nephrology Dialysis Transplantation. 2004 ; Vol. 19, No. 4. pp. 917-924.
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T1 - Peritoneal dialysis with solutions low in glucose degradation products is associated with improved biocompatibility profile towards peritoneal mesothelail cells

AU - Witowski, Janusz

AU - Korybalska, Katarzyna

AU - Ksiazek, Krzysztof

AU - Wiśniewska-Elnur, Justyna

AU - Jörres, Achim

AU - Lage, Christina

AU - Schaub, Thomas P.

AU - Passlick-Deetjen, Jutta

AU - Breborowicz, Andrzej

AU - Grzegorzewska, Alicja

AU - Ksiazek, Andrzej

AU - Liberek, Tomasz

AU - Lichodziejewska-Niemierko, Monika

AU - Majdan, Maria

AU - Rutkowski, Bolesław

AU - Stompór, Tomasz

AU - Sułowicz, Władysław

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N2 - Background. In vitro experiments point to a better biocompatibility profile of new pH-neutral peritoneal dialysis fluids (PDFs) containing low levels of glucose degradation products (GDPs). The present study examines the impact on human peritoneal mesothelial cells (HPMCs) of equilibrated dialysates obtained during dialysis with either conventional or new PDFs. Methods. Peritoneal dialysate was collected from 17 patients participating in a randomized, controlled, cross-over trial comparing a pH-neutral low-GDP solution (Balance) to a conventional solution (S-PDF). All patients were treated sequentially for 3 months with both PDFs. At the end of each treatment phase, peritoneal effluent was drained after a timed 10 h dwell. Samples of dialysate were then mixed with standard culture medium and added to in vitro cultures of HPMCs from healthy donors. Cells were assessed for proliferation, viability and cytokine release. Results. Proliferation and viability of HPMCs were better preserved in the presence of effluent obtained during dialysis with Balance (P < 0.046 and P < 0.035, respectively). The proliferative response of HPMCs correlated with the concentration of fibronectin in dialysates (P=0.0024). Effluent drained following a 3 month dialysis with Balance contained significantly increased levels of fibronectin (P=0.004) and CA125 antigen (P = 0.0004) compared with S-PDF. There was no significant difference in constitutive and stimulated cytokine (IL-6, MCP-1, VEGF) synthesis by HPMCs treated with either Balance- or S-PDF-derived effluents. Conclusions. These results suggest that therapy with new pH-neutral low-GDP solutions contribute to an intraperitoneal milieu that improves mesothelial cell proliferation and viability. It may positively impact on the preservation of the peritoneal membrane integrity during long-term dialysis.

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