Interleukin-6 levels decrease in effluent from patients dialyzed with bicarbonate/lactate-based peritoneal dialysis...

Area of Science:

• Nephrology
• Biomaterials Science
• Inflammation Research

Background:

• Conventional lactate-buffered peritoneal dialysis (PD) solutions exhibit bioincompatible properties like acidic pH and glucose degradation products (GDPs).
• These factors, alongside inflammation, are implicated in the progression of peritoneal membrane dysfunction among PD patients.
• A novel bicarbonate/lactate buffered PD solution with physiological pH and reduced GDPs has demonstrated enhanced biocompatibility in preliminary studies.

Purpose of the Study:

• To evaluate the impact of a new bicarbonate/lactate (B/L) buffered PD solution on intraperitoneal inflammatory markers.
• To compare the concentrations of interleukin-6 (IL-6), tumor necrosis factor alpha (TNFalpha), and vascular endothelial growth factor (VEGF) in PD effluents between B/L and conventional lactate-based solutions.

Main Methods:

• A randomized controlled trial involving 92 continuous ambulatory peritoneal dialysis (CAPD) patients.
• Patients were assigned to receive either a control lactate-based solution (C) or the new bicarbonate/lactate (B/L) solution for 6 months.
• Overnight PD effluents were collected at baseline, 3 months, and 6 months, and analyzed for IL-6, TNFalpha, and VEGF using ELISA.

Main Results:

• The B/L solution group showed a significant reduction in effluent IL-6 levels at both 3 and 6 months.
• A significant decrease in VEGF levels was observed at 3 months in the B/L group.
• No significant changes in IL-6 or VEGF were noted in the control group, and TNFalpha levels remained unchanged in both groups.

Conclusions:

• Treatment with the bicarbonate/lactate (B/L) PD solution is associated with reduced IL-6 synthesis and VEGF secretion.
• These findings suggest that the B/L solution mitigates intraperitoneal inflammation and may reduce the potential for angiogenesis.
• The use of B/L solution holds promise for restoring peritoneal homeostasis and preserving long-term peritoneal membrane function in PD patients.