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Mesothelial dysplastic changes and lipid peroxidation induced by 7.5% icodextrin.

Lazaro Gotloib1, Valeri Wajsbrot, Avshalom Shostak

  • 1Department of Nephrology and Hypertension and the Research Center for Experimental Nephrology, Ha'Emek Medical Center, Afula, Israel. gotloib@netvision.net.il

Nephron
|August 21, 2002
PubMed
Summary

Icodextrin dialysis solution may cause DNA damage and cell death in mesothelial cells through lipid peroxidation. This raises concerns about the safety of 7.5% icodextrin for peritoneal dialysis patients.

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Area of Science:

  • Biomedical Science
  • Cell Biology
  • Toxicology

Background:

  • Icodextrin biocompatibility is debated, with conflicting data on its safety compared to glucose solutions.
  • Previous studies indicated potential cytotoxic effects of icodextrin on monocytes and mesothelial cells.

Purpose of the Study:

  • To investigate the in vivo and in situ biocompatibility of 7.5% icodextrin dialysis solution.
  • To assess the effects of icodextrin on mesothelial cell populations and indicators of oxidative stress.

Main Methods:

  • Mice received daily intraperitoneal injections of 7.5% icodextrin for 30 days, with mesothelial cell analysis at various time points.
  • Rats underwent peritoneal dialysis with glucose, amino acids, or icodextrin solutions, with thiobarbituric acid reactive substances (TBARS) measured.

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Main Results:

  • Icodextrin exposure led to reduced mesothelial cell density, increased cell size, higher nuclear/cytoplasmic index, and increased apoptosis.
  • Significant increases in lipid peroxidation (TBARS) were observed in rats exposed to icodextrin.

Conclusions:

  • 7.5% icodextrin induces lipid peroxidation, DNA injury, and cellular apoptosis in mesothelial cells.
  • The findings question the safety of 7.5% icodextrin for patients undergoing peritoneal dialysis.