To compare the effect of glucose (Glu) and icodextrin (Ico) dialysate on in vitro culture of mesothelial cells (MC) from peritoneal dialysis (PD) patients.
Design
Prospective, controlled comparative study on the effects of two PD solutions.
Setting
A tertiary-care public university hospital.
Patients
Sixteen PD patients regularly using Glu dialysate were asked to collect an 8-hour dwell peritoneal effluent on 2 different days, with an interval shorter than 7 days. In the first collection, 2.27% Glu solution and in the last, 7.5% Ico solution was infused. Human MC were isolated from the nocturnal peritoneal effluent bags and grown ex vivo.
Main Outcome Measures
Mesothelial cell proliferative capacity ex vivo.
Results
Mesothelial cells were present in all patient dialysates except that of a single patient's Glu dialysate. The number of MC drained was similar with both solutions. After the initial culture reached confluence, MC were identified in 14 and 12 patients receiving Ico and Glu, respectively. However, in 1 patient using Ico and in 2 using Glu, the MC count at this stage was so low that further subculture could not be performed. Cells from Ico-derived solutions exhibited a higher degree of proliferation than cells from Glu-derived solutions. The morphology of MC was also different. Cells from drained effluent were typical in 11 patients using Glu solution in contrast with 14 patients using Ico. At confluence, the percentages of typical appearance were 50% and 92.9% (p < 0.05) in Glu and Ico respectively.
Conclusions
Mesothelial cells taken from icodextrin effluent show a greater proliferation ex vivo than those taken from glucose effluent.
AlobaidiH.M., ColesG.A., DaviesM., LloydD.Host defense in continuous ambulatory peritoneal dialysis: The effect of the dialysate on phagocyte function.Nephrol Dial Transplant1986; 1: 16–21.
3.
Van BronswijkH., VerbrughH.A., HeeziusH.C., van der MeulenJ., OeP.L., VerhoefJ.Dialysis fluids and local host resistance in patients on continuous ambulatory peritoneal dialysis.Eur J Clin Microbiol Infect Dis1988; 7: 368–73.
4.
TopleyN., AlobaidiH.M., DaviesM., ColesG.A., WilliamsJ.D., LloydD.The effect of dialysate on peritoneal phagocyte oxidative metabolism.Kidney Int1988; 34: 404–11.
5.
HarveyD.M., SheppardK.J., MorganA.G., FletcherJ.Effect of dialysate fluids on phagocytosis and killing by normal neutrophils.J Clin Microbiol1987; 25: 1424–7.
6.
IngB.L., GuptaD.K., NawabZ.M., ZhouF.Q., RahmanM.A., DaugirdasJ.T.Suppression of neutrophil superoxide production by conventional peritoneal dialysis solutions.Int J Artif Organs1988; 11: 351–4.
7.
SelgasR., Fernandez–ReyesM.J., BosqueE., BajoM.A., BorregoF., JiménezC.Functional longevity of the peritoneum. How long is continuous peritoneal dialysis possible? Results of a prospective medium long-term study.Am J Kidney Dis1994; 23: 64–73.
8.
SelgasR., BajoM.A., del PesoG., JiménezC.Preserving the peritoneal dialysis membrane in long-term peritoneal dialysis patients.Semin Dial1995; 8: 326–32.
9.
SelgasR., BajoM.A., PaivaA., del PesoG., DíazC., AguileraA.Stability of the peritoneal membrane in long-term peritoneal dialysis patients.Adv Ren Replace Ther1998; 5: 168–78.
10.
DobbieJ.W.Pathogenesis of peritoneal fibrosing syndromes (sclerosing peritonitis) in peritoneal dialysis.Perit Dial Int1992; 12: 14–27.
11.
TopleyN.Membrane longevity in peritoneal dialysis: Impact of infection and bio-incompatible solutions.Adv Ren Replace Ther1998; 5: 179–84.
12.
Van BiesenW., VanholderR., LameireN.Recent developments in osmotic agents for peritoneal dialysis.Adv Ren Replace Ther1998; 5: 218–31.
MistryC.D., GokalR., PeersE., and the MIDAS Study Group. A randomized multicenter clinical trial comparing isosmolar icodextrin with hyperosmolar glucose solutions in CAPD. MIDAS Study Group. Multicenter investigation of icodextrin in ambulatory peritoneal dialysis.Kidney Int1994; 46: 496–503.
15.
PosthumaN., ter WeeP.M., DonkerA.J., OeP.L., van DorpW., PeersE.M.Serum disaccharides and osmolality in CCPD patients using icodextrin or glucose as daytime dwell.Perit Dial Int1997; 17: 602–7.
16.
PosthumaN., ter WeeP.M., VerbrughH.A., OeP.L., PeersE.M., SayersJ.Icodextrin instead of glucose during the daytime dwell in CCPD increases ultrafiltration and 24-h dialysate creatinine clearance.Nephrol Dial Transplant1997; 12: 550–3.
17.
WilkieM.E., PlantM.J., EdwardsL., BrownC.B.Icodextrin 7.5% dialysate solution (glucose polymer) in patients with ultrafiltration failure: Extension of CAPD technique survival.Perit Dial Int1997; 17: 84–7.
18.
de FijterC.W., VerbrughH.A., OeL.P., HeeziusE., DonkerA.J., VerhoefJ.Biocompatibility of a glucose-polymer-containing peritoneal dialysis fluid.Am J Kidney Dis1993; 21: 411–18.
19.
JörresA., GahlG.M., TopleyN., NeubauerA., LudatK., MüllerC.In-vitro biocompatibility of alternative CAPD fluids; comparison of bicarbonate-buffered and glucose-polymer-based solutions.Nephrol Dial Transplant1994; 9: 785–90.
DawnayA.B., MillarD.J.Glycation and advanced glycation end-product formation with icodextrin and dextrose.Perit Dial Int1997; 17: 52–8.
22.
PlumJ., SchoenickeG., GrabenseeB.Osmotic agents and buffers in peritoneal dialysis solution: Monocyte cytokine release and in vitro cytotoxicity.Am J Kidney Dis1997; 30: 413–22.
23.
BarreD.E., ChenC., CookerL., MoberlyJ.B.Decreased in vitro formation of AGEs with Extraneal solution compared to dextrose-containing peritoneal dialysis solutions.Adv Perit Dial1999; 15: 12–16.
24.
CookerL.A., ChooG.C., LuneburgP., LamelaJ., HolmesC.J.Effect of icodextrin peritoneal dialysis solution on cell proliferation in vitro.Adv Perit Dial1999; 15: 17–20.
25.
LiberekT., TopleyN., MistryC.D., ColesG.A., MorganT., QuirkR.A.Cell function and viability in glucose polymer peritoneal dialysis fluid.Perit Dial Int1993; 13: 104–11.
26.
RooneyO.B., DoddP.D., GokalR., WalkerM.G.Dialysis fluid cytotoxicity and inhibition of host defense in cultured human mesothelial cells are neutralized rapidly with incubation in the peritoneum.Nephrol Dial Transplant1996; 11: 2472–7.
27.
DíazC., SelgasR., CastroM.A., BajoM.A., Fernández de CastroM., MolinaS.Ex vivo proliferation of mesothelial cells directly obtained from peritoneal effluent: its relationship with peritoneal antecedents and functional parameters.Adv Perit Dial1998; 14: 19–24.
28.
LeavesleyD.I., StanleyJ.M., FaullR.J.Epidermal growth factor modifies the expression and function of extracellular matrix adhesion receptors expressed by peritoneal mesothelial cells from patients on CAPD.Nephrol Dial Transplant1999; 14: 1208–16.
29.
Fernandez de CastroM., SelgasR., JiménezC., BajoM.A., MartinezV., RomeroJ.R.Cell populations present in the nocturnal peritoneal effluent of patients on continuous ambulatory peritoneal dialysis and their relationship with peritoneal function and incidence of peritonitis.Perit Dial Int1994; 14: 265–70.
30.
PosthumaN., ter WeeP.M., DonkerA.J., DekkerH.A., OeP.L., VerbrughH.A.Peritoneal defense using icodextrin or glucose for daytime dwell in CCPD patients.Perit Dial Int1999; 19: 334–42.
31.
BreborowiczA., PolubinskaA., OreopoulosD.G.Changes in volume of peritoneal mesothelial cells exposed to osmotic stress.Perit Dial Int1999; 19: 119–23.
32.
SitterT., HaslingerB., MandlS., FrickeH., HeldE., SellmayerA.High glucose increases prostaglandin E2 synthesis in human peritoneal mesothelial cells: role of hyperosmolarity.J Am Soc Nephrol1998; 9: 2005–12.
