Effect of icodextrin peritoneal dialysis solution on cell proliferation in vitro

Area of Science:

• Biomaterials Science
• Nephrology
• Cell Biology

Background:

• Peritoneal dialysis (PD) solutions with icodextrin offer sustained ultrafiltration for long dwells.
• The biocompatibility of PD solutions, particularly concerning glucose degradation products (GDPs), requires further investigation.
• Dextrose-based solutions are commonly used but may generate harmful GDPs.

Purpose of the Study:

• To compare the in vitro biocompatibility of icodextrin-based PD solutions with dextrose-based PD solutions.
• To evaluate the impact of these solutions on fibroblast proliferation.
• To assess the role of GDPs in observed cellular effects.

Main Methods:

• Murine fibroblasts were exposed to pH-adjusted peritoneal dialysis solutions (icodextrin and dextrose) mixed with culture medium.
• Cell proliferation was measured by comparing cell growth in the presence of test solutions versus control (medium only).
• Levels of glucose degradation products, specifically acetaldehyde, were quantified in the solutions.

Main Results:

• No significant difference in fibroblast proliferation was observed between heat-sterilized icodextrin (Extraneal), heat-sterilized 1.5% dextrose (Dianeal), or filter-sterilized 4.25% dextrose (Dianeal).
• Heat-sterilized 4.25% dextrose (Dianeal) significantly reduced fibroblast growth compared to controls.
• Icodextrin solutions (Extraneal) exhibited lower levels of acetaldehyde, a GDP, compared to dextrose solutions.

Conclusions:

• Icodextrin-containing peritoneal dialysis solutions demonstrate enhanced in vitro biocompatibility compared to dextrose solutions.
• The improved biocompatibility may be attributed to the lower levels of glucose degradation products in icodextrin solutions.
• These findings suggest potential benefits of icodextrin solutions for patients undergoing long-dwell peritoneal dialysis.