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Bicarbonate-based dialysis solution preserves granulocyte functions

G J Dobos1, J Böhler, J Kuhlmann

  • 1Department of Nephrology, University Hospital Freiburg, Germany.

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|January 1, 1994
PubMed
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Bicarbonate-based dialysis solution better preserves neutrophil functions compared to lactate-based solutions, enhancing immune cell activity crucial for preventing peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients.

Area of Science:

  • Nephrology
  • Immunology
  • Cell Biology

Background:

  • Intraperitoneal phagocytes are vital for local defense against peritonitis in continuous ambulatory peritoneal dialysis (CAPD).
  • Conventional lactate-based dialysis solutions (LBDS) may impair crucial immune cell functions.
  • Investigating alternative dialysis solutions like bicarbonate-based dialysis solution (BBDS) is essential for improving patient outcomes.

Purpose of the Study:

  • To evaluate the impact of LBDS (pH 5.2) and BBDS on neutrophil functions, including actin polymerization, phagocytosis, and chemotaxis.
  • To compare the efficacy of BBDS with conventional LBDS and a control (PBS-pH 7.4) in preserving neutrophil functions.

Main Methods:

  • Neutrophils were isolated and incubated with LBDS (pH 5.2 and 7.4) or BBDS (pH 7.4).

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  • Cellular responses were measured by C5a-induced actin polymerization (AP), phagocytosis of zymosan particles, and chemotaxis.
  • Phosphate-buffered saline (PBS-pH 7.4) served as the control.

    • Main Results:

    • LBDS-pH 5.2 significantly inhibited C5a-induced AP, phagocytosis, and chemotaxis in neutrophils.
    • BBDS demonstrated a notable improvement in AP, nearly normalizing phagocytosis.
    • Chemotaxis was markedly enhanced in neutrophils treated with BBDS, particularly with low-glucose (Bic 20) and high-glucose (Bic 30) formulations.

    Conclusions:

    • Bicarbonate-based dialysis solution, especially at low osmolality, preserves neutrophil functions more effectively than conventional LBDS-pH 5.2.
    • BBDS supports cytoskeletal integrity and immune cell activity, potentially reducing the risk of CAPD-related peritonitis.