Abstract

Continuous exposition of the peritoneal membrane to conventional dialysis solutions is an important risk factor for inducing structural and functional alterations. To compare in vitro mouse fibroblast NIH-3T3 cell viability after exposition to a neutral pH dialysis solution in comparison to cells exposed to a standard solution. Experimental study to compare the effects of a conventional standard or a neutral-pH, low-glucose degradation products peritoneal dialysis solution on the viability of exposed fibroblasts in cell culture. Both solutions were tested in all the commercially available glucose concentrations. Cell viability was evaluated with tetrazolium salt colorimetric assay. Fibroblast viability was significantly superior in the neutral pH solution in comparison to control, in all three glucose concentrations (Optical density in nm-means ± SD: 1.5% 0.295 ± 0.047 vs. 0.372 ± 0.042, p < 0.001; 2.3% 0.270 ± 0.036 vs. 0.337 ± 0.051, p < 0.001; 4.25% 0.284 ± 0.037 vs. 0.332 ± 0.032, p < 0.001; control vs. neutral pH respectively, Student t Test). There was no significant difference in cell viability between the three concentrations of glucose when standard solution was used (ANOVA p = 0.218), although cell viability was higher after exposition to neutral pH peritoneal dialysis fluid at 1.5% in comparison to 2.3 and 4.25% glucose concentrations (ANOVA p = 0.008: Bonferroni 1.5% vs. 2.3% p = 0.033, 1.5% vs. 4.25% p = 0.014, 2.3% vs. 4.25% p = 1.00). Cell viability was better in neutral pH dialysis solution, especially in the lower glucose concentration. A more physiological pH and lower glucose degradation products may be responsible for such results.

Highlights

  • Continuous exposition of the peritoneal membrane to conventional dialysis solutions is an important risk factor for inducing structural and functional alterations

  • Cells viability was significantly greater on the neutral pH than on the acid solution, at all tested glucose concentrations, measured by optical density: 0.295 ± 0.047 vs. 0.372 ± 0.042, p < 0.001 for 1.5% glucose control and neutral pH, respectively; 0.270 ± 0.036 vs. 0.337 ± 0.051, p < 0.001 for 2.3% control and neutral pH, respectively; 0.284 ± 0.037 vs. 0.332 ± 0.032, p < 0.001 for 4.25% control and neutral pH solution, respectively

  • The current experiments demonstrated that cells viability is greater when fibroblasts are exposed, in vitro, to a neutral pH than to an standard peritoneal dialysis (PD) solution

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Summary

Introduction

Continuous exposition of the peritoneal membrane to conventional dialysis solutions is an important risk factor for inducing structural and functional alterations. Methods: Experimental study to compare the effects of a conventional standard or a neutral-pH, low-glucose degradation products peritoneal dialysis solution on the viability of exposed fibroblasts in cell culture. Both solutions were tested in all the commercially available glucose concentrations. Small vessels changes, thickened and fibrotic sub-mesothelial compact zone have been observed at peritoneal biopsies.[2] Functional changes have included ultrafiltration loss, small solutes clearance decline and, eventually, technique failure.[3] Using biocompatible dialysis solutions is paramount in accomplishing long-term membrane survival.[4] A neutral-pH, poor GDP dialysis solution, presented in a double-chambered bag has been developed in anticipation of improved biocompatibility.[3] Previous clinical and experimental studies have suggested its beneficial effects.[3,5,6] The aim of the current study was to compare mouse fibroblast NIH-3T3 - a well characterized cell lineage - viability after exposition to either the standard acid or the neutral-pH dialysis solution

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