Abstract

To compare effects of N-acetylglucosamine (NAG)-based and glucose-based dialysis fluids on the function of peritoneal leukocytes in conditions of peritoneal dialysis. In vitro experiments on ex vivo isolated rat peritoneal leukocytes. Peritoneal leukocytes were isolated from rats on chronic peritoneal dialysis. On alternate days, fluid exchanges were performed with NAG-based or glucose-based dialysis solutions. After a 4-hour dwell, dialysate was drained and peritoneal leukocytes were incubated in vitro +/- lipopolysaccharide (LPS). Production of nitrites (index of NO synthesis), tumor necrosis factor alpha (TNFalpha), interleukin-1beta (IL-1beta), and interferon gamma (IFN-gamma) by unstimulated or stimulated peritoneal leukocytes originating from NAG-based or glucose-based fluid was measured. Dialysate cell count was lower during exchanges with NAG-based fluid (2113+/-615 cells/microL) as compared to glucose-based fluid (3643+/-1108 cells/microL; p < 0.01). Differential cell count was similar in both studied groups. Unstimulated peritoneal leukocytes from NAG-based dialysate produced more NO (nitrites) (0.65+/-0.07 micromol per 10(6) cells) than did cells from glucose-based dialysate (0.26+/-0.09 micromol per 106 cells, p < 0.01). Stimulated peritoneal leukocytes from NAG-based dialysate produced more cytokines than did cells from glucose-based dialysate: TNFalpha, 135.2+/-37.0 pg versus 70.2+/-21.8 pg per 10(6) cells respectively, p < 0.01; IL-1beta, 143.2+/-60.9 pg versus 99.1+/-22.4 pg per 10(6) cells respectively, p < 0.05; IFN-gamma, 16.2+/-12.5 pg versus 6.0+/-1.8 pg per 10(6) cells respectively, p < 0.01. We demonstrated that rat peritoneal leukocytes exposed in vivo to NAG-based dialysis fluid have better ability to produce inflammatory mediators than do peritoneal leukocytes from the same donor, but exposed in vivo to glucose-based dialysis solution.

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