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Jornal Brasileiro de Nefrologia 2014Continuous exposition of the peritoneal membrane to conventional dialysis solutions is an important risk factor for inducing structural and functional alterations.
INTRODUCTION
Continuous exposition of the peritoneal membrane to conventional dialysis solutions is an important risk factor for inducing structural and functional alterations.
OBJECTIVE
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.
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. Cell viability was evaluated with tetrazolium salt colorimetric assay.
RESULTS
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).
CONCLUSION
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.
Topics: Animals; Cell Survival; Dialysis Solutions; Fibroblasts; Hydrogen-Ion Concentration; Mice; Peritoneal Dialysis
PubMed: 25055354
DOI: 10.5935/0101-2800.20140024 -
American Journal of Hospital Pharmacy Feb 1991The stability of cefazolin sodium was studied in two commonly used peritoneal dialysis solutions. Cefazolin (as the sodium salt) 250 mg was added to 500-mL bags of...
The stability of cefazolin sodium was studied in two commonly used peritoneal dialysis solutions. Cefazolin (as the sodium salt) 250 mg was added to 500-mL bags of dialysis solution containing 1.5% or 4.25% dextrose injection to yield a target concentration of 0.5 mg/mL. Of 18 bags containing 1.5% dextrose injection, six were stored at 4 degrees C, six at 25 degrees C, and six at 37 degrees C. Similarly, of 18 bags containing 4.25% dextrose injection, groups of six were stored at each temperature. Samples were measured for cefazolin concentration by high-performance liquid chromatography at 0, 3, 7, 10, and 14 days for solutions stored at 4 degrees C; 0, 1, 2, 3, 8, and 11 days for solutions stored at 25 degrees C; and 0, 6, 12, and 24 hours for solutions stored at 37 degrees C. The cefazolin concentration in both solutions was greater than or equal to 90% of the initial concentration for 14 days at 4 degrees C, 8 days at 25 degrees C, and 1 day at 37 degrees C. On day 11 at 25 degrees C, however, the loss of cefazolin was 11% for the solution containing 1.5% dextrose injection and 15% for the 4.25% dextrose injection. The sterility of the solutions was not determined. Cefazolin sodium was stable in peritoneal dialysis solutions containing 1.5% and 4.24% dextrose injection for 14 days at 4 degrees C, 8 days at 25 degrees C, and 24 hours at 37 degrees C.
Topics: Cefazolin; Dialysis Solutions; Drug Stability; Glucose; Temperature
PubMed: 2003503
DOI: No ID Found -
American Journal of Hospital Pharmacy Jan 1990The stability of cefotaxime sodium at room and body temperatures in peritoneal dialysis solutions containing 1.5% or 4.25% dextrose was determined. Cefotaxime sodium 2 g...
The stability of cefotaxime sodium at room and body temperatures in peritoneal dialysis solutions containing 1.5% or 4.25% dextrose was determined. Cefotaxime sodium 2 g was added to three 2-L bags of dialysis solution containing 1.5% dextrose, and cefotaxime sodium 500 mg was added to three 500-mL bags of dialysis solution containing 4.25% dextrose. The bags were stored at 25 or 37 degrees C Samples from bags stored at 25 degrees C were drawn aseptically at 0, 12, 24, 48, and 72 hours, and samples from bags stored at 37 degrees C were drawn at 0, 6, 12, and 24 hours. The pH of each sample was determined, and the cefotaxime concentration was measured by a stability-indicating high-performance liquid chromatographic method. At 37 degrees C the initial mean cefotaxime concentration declined to 97.9% at six hours, 89.1% at 12 hours, and 68.8% at 24 hours in the 1.5% dextrose solution; the mean percentages remaining in the solution containing 4.25% dextrose were 96.4%, 86.1%, and 71.0% at 6, 12, and 24 hours, respectively. At 25 degrees C the initial cefotaxime concentration declined to 92.4%, 84.4%, and 74.2% at 24, 48, and 72 hours, respectively, in 1.5% dextrose solution and to 92.0%, 84.3%, and 80.3% at 24, 48, and 72 hours, respectively, in 4.25% dextrose solution. In both solutions, cefotaxime concentration decreased by more than 10% at and after 12 hours at 37 degrees C and between 24 and 48 hours at 25 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Cefotaxime; Chromatography, High Pressure Liquid; Dialysis Solutions; Drug Stability; Peritoneal Dialysis; Temperature
PubMed: 2301423
DOI: No ID Found -
Peritoneal Dialysis International :... 2013The concentration or appearance rate of cancer antigen 125 (CA125) in peritoneal dialysis (PD) effluent has been used for many years as a biomarker for mesothelial cell... (Review)
Review
The concentration or appearance rate of cancer antigen 125 (CA125) in peritoneal dialysis (PD) effluent has been used for many years as a biomarker for mesothelial cell mass in patients on PD. However, this marker has limitations, and emerging evidence has raised doubts as to its significance. This review explores our current understanding of CA125, its prominent role in studies of "biocompatible" PD solutions, and the ongoing uncertainty concerning its interpretation as a measure of mesothelial cell health.
Topics: Biomarkers; CA-125 Antigen; Cell Death; Cell Proliferation; Dialysis Solutions; Epithelial Cells; Humans; Peritoneal Dialysis
PubMed: 23843586
DOI: 10.3747/pdi.2012.00320 -
Peritoneal Dialysis International :... 2000
Topics: Absorption; Child; Dialysis Solutions; Humans; Peritoneal Dialysis; Peritoneum
PubMed: 11216547
DOI: No ID Found -
Giornale Italiano Di Nefrologia :... Feb 2024
Topics: Peritoneal Dialysis; Dialysis Solutions; Forecasting
PubMed: 38426676
DOI: No ID Found -
Kidney International. Supplement Dec 2003In vitro biocompatibility performance of Physioneal. toneal dialysis (PD) has been a successful and effective form of chronic renal replacement therapy since its... (Review)
Review
In vitro biocompatibility performance of Physioneal. toneal dialysis (PD) has been a successful and effective form of chronic renal replacement therapy since its introduction over 20 years ago. Despite its overall success, there is a growing body of evidence that suggests shortcomings in the preservation of membrane integrity. This has led to the development of several second-generation PD solutions that demonstrate improved biocompatibility. Physioneal, a neutral pH, bicarbonate/lactate-buffered solution, was one of the first of these new PD solutions to become commercially available. This review will focus on one of the first preclinical stages in the development of Physioneal: studies on in vitro biocompatibility testing. Studies in leukocyte, mesothelial cell, and fibroblast populations demonstrated significantly improved biocompatibility of neutral pH, bicarbonate/lactate-based solutions compared to conventional solutions. The solutions contributed to improved leukocyte viability and response to bacterial infection (e.g., phagocytosis, superoxide radical generation, and endotoxin-stimulated cytokine release). Studies on peritoneal mesothelial cells demonstrate improved cell viability, proliferation, and response to proinflammatory stimuli, and a reduced potential for angiogenesis and peritoneal fibrosis, all suggesting a better preservation of membrane structure and function. The bicarbonate/lactate-based solutions demonstrated decreased cytotoxicity and preserved cell growth in fibroblast cultures as well. In vitro biocompatibility testing has clearly demonstrated that neutral pH, bicarbonate/lactate-buffered Physioneal solutions are superior to conventional solutions in preserving cell viability and function in cell populations that contribute to peritoneal homeostasis. This positive assessment now provides a foundation and rationale for moving forward with the next stages in preclinical testing: in vivo animal models and human ex vivo studies.
Topics: Animals; Bicarbonates; Biocompatible Materials; Dialysis Solutions; Epithelial Cells; Fibroblasts; Glucose; Glycation End Products, Advanced; Humans; Hydrogen-Ion Concentration; Lactates; Leukocytes; Materials Testing; Organic Chemicals; Peritoneum; Predictive Value of Tests
PubMed: 14870879
DOI: 10.1046/j.1523-1755.2003.08807.x -
The International Journal of Artificial... Aug 1998
Topics: Dialysis Solutions; Epithelium; Glucose; Humans; Peritoneal Dialysis; Peritoneal Dialysis, Continuous Ambulatory; Peritoneum; Time Factors
PubMed: 9803343
DOI: No ID Found -
Journal of Nephrology Feb 2021
Topics: Calcium; Cinacalcet; Dialysis Solutions; Humans; Hypocalcemia; Renal Dialysis
PubMed: 32342328
DOI: 10.1007/s40620-020-00741-0 -
Peritoneal Dialysis International :... 2009To investigate the possible effects of different concentrations of ionized sodium (NaI) on peritoneal ultrafiltration (UF) rate using lactate (Lac) and... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To investigate the possible effects of different concentrations of ionized sodium (NaI) on peritoneal ultrafiltration (UF) rate using lactate (Lac) and lactate/bicarbonate (Lac/Bic) dialysis solutions.
DESIGN
Two random consecutive (after an interval of 48 hours) peritoneal equilibration tests (PETs) were performed in 13 patients (4 males and 9 females) on regular continuous ambulatory peritoneal dialysis (PD) treatment for at least 3 months. Two different PD solutions containing anhydrous glucose 3.86% were used: a 40 mmol/L Lac solution and a 15/25 mmol/L mixed Lac/Bic solution. Concentrations of total sodium (NaT) and NaI were measured by flame photometer and direct ion-selective electrode respectively.
RESULTS
Dialysate concentrations of NaT were not different during PETs using Lac and Lac/Bic. Dialysate concentrations of NaI in fresh PD solutions were different (133.3 +/- 1.7 vs 128.2 +/- 3.9 mmol, p < 0.0001); however, these differences disappeared just after the end of the infusion of the fresh solutions. Peritoneal UF rate was not significantly different during PETs using Lac versus Lac/Bic (609 +/- 301 mL vs 542 +/- 362 mL). The dialysate-to-plasma ratios of sodium concentrations at 60 minutes of the PETs (which are expressions of free water transport) were not different using Lac versus Lac/Bic (0.89 +/- 0.04 vs 0.89 +/- 0.04 respectively, p = 0.96). All the other classical parameters of the PET were not different between Lac and Lac/Bic.
CONCLUSIONS
The higher dialysate concentrations of NaI due to lower dialysate pH and consequently the higher effective osmolality of the fresh Lac PD solutions did not influence peritoneal UF rate, probably because of the fast reduction of NaI concentrations due to rapid correction of dialysate pH at the end of the infusion of Lac solutions into the peritoneal cavity.
Topics: Adult; Aged; Bicarbonates; Dialysis Solutions; Female; Humans; Lactic Acid; Male; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Peritoneum; Sodium; Time Factors; Ultrafiltration
PubMed: 19293352
DOI: No ID Found