Dialysis solutions buffered with lactate or bicarbonate: in vitro comparison of two dialysis solutions on human...

In order to evaluate the injury to the mesothelial cell layer during long-term peritoneal dialysis (PD), a dialysis solution (solution A), buffered with bicarbonate, stabilized with 10 mmol/L glycylglycine, and sterilized by filtration (0.22 micron double filtration, pH = 7.4), was compared to traditional heat sterilized lactate solution (solution B) on human mesothelial cell cultures. The respective effects of both solutions were evaluated on first passage cells by 3H thymidine incorporation after 72-, 96-, 120-, and 144-h contact. Mesothelial cells to be cultured were obtained from the omentum biopsies of 7 end-stage renal disease (ESRD) patients (during first peritoneal catheter placement) and from 7 non-ESRD patients undergoing abdominal surgery. Solution A (diluted 1/5) induced a time-dependent stimulation of growth in 6 cases of ESRD patient cell cultures, and inhibition occurred only in 1 case. Stimulation was also observed in 5 non-ESRD patient cell cultures, and no effect occurred in 2 cases. Solution B inhibited growth in all the cultures except in 1 case of an ESRD patient in which no effect was observed. This study shows that solution A induced mesothelial cell proliferation, while an inhibitory effect of solution B was observed. No significant differences were observed between the sensitivity of mesothelial cells from ESRD and non-ESRD patients. Further analysis will be carried out to identify precisely the cause of the differences observed: buffer or glycylglycine by themselves and/or glucose by-products.