Comparative in vitro study of different peritoneal dialysis solutions on cytokine production by peripheral blood...

Peritoneal dialysis solutions (PDS), new and conventional, do not yet have a clinical biocompatibility profile. We aimed at a comparative laboratory profile based on the effect of PDS on peripheral blood mononuclear cell (PBMC) cytokine release.

PBMCs from 19 healthy volunteers were incubated at a concentration of 10(6)/ml in fresh PDS and control medium (RPMI 1640), and stimulated or not with 10 microg/ml Escherichia coli lipopolysaccharide. The tested PDS were glucose/lactate 1.5 and 4.25%, glucose/pyruvate 1.0 and 4.0%, icodextrin and amino acid solutions. The initial incubation in culture flasks for 15 min was followed by 1:1 dilution with RPMI and by additional incubation for 22 h as a 'recovery period'. At the end, the supernatants were tested for cytokines IL-6 and TNFalpha by ELISA.

The hypertonic glucose solutions, irrespective of the buffer, had the most adverse effect on PBMC cytokine release. The icodextrin and amino acid solutions seemed close to the isotonic glucose PDS. The substitution of pyruvate for lactate buffer seemed to offer an advantage only for the hypertonic glucose-based solutions.

Icodextrin and amino acid solutions seem to offer an advantage only compared to hypertonic glucose PDS.