Effects of Peritoneal Dialysis Solutions on the Murine Peritoneal Microcirculation

Abstract

Peritoneal dialysis is often used as a treatment for patients with end‐stage renal disease, however it is limited by the development of progressive fibrosis. This study uses intravital microscopy to examine the acute impact of clinically available dialysis solutions on the peritoneal inflammatory response.To test whether dialysis fluids elicit, or inhibit an inflammatory response, mice (C57Bl/6) were given either saline or TNF intraperitoneally (IP). Three hours later, the test solution was administered IP. After a 60‐minute dwell, the peritoneal microvasculature was examined. This study compares dextrose‐based, lactate buffered Dianeal 1.5%, 2.5%, and 4.25%, as well as the glucose‐based, bicarbonate‐buffered Physioneal 3.86% to Ringer's Lactate.In non‐TNF stimulated mice, Dianeal 4.25% was associated with a 5‐fold increase in leukocyte rolling, compared to Ringer's Lactate (9.1± 3.7 vs 49.1± 11.2, p<0.0001). This effect was not seen with Physioneal 3.86%. In the TNF‐stimulated mice, reduced leukocyte rolling was observed in all groups, except for Physioneal 3.86%. The cytokine‐induced increase in leukocyte adhesion within the peritoneal venules was not altered by the presence of TNF, except when treated with the Physioneal 3.86%.The acute presence of lactate‐buffered high glucose peritoneal dialysis fluid is associated with a marked increase in leukocyte rolling, but not adhesion, in the peritoneal microcirculation. This effect is not exacerbated in the presence of the cytokine TNF. The use of a bicarbonate buffer alleviates the pro‐inflammatory properties of high glucose and TNF stimulation.