[Effect of pH and osmolality in dialysate fluids on active oxygen generation by polymorphonuclear leukocytes]

In order to clarify the role of polymorphonuclear leukocytes (PMNs) in peritonitis during continuous ambulatory peritoneal dialysis (CAPD). I investigated the active oxygen generation and intracellular ATP content of PMNs in dialysate fluids. PMNs, prepared from peripheral blood, were suspended in CAPD dialysates which had different pH and osmolality. PMNs were collected by centrifugation. These PMNs were stimulated with phorbol myristate acetate (PMA) in phosphate-buffered saline (PBS), and active oxygen generation of PMNs were measured by chemiluminescence method. Intracellular ATP content of PMNs was measured by luciferin-luciferase dependent chemiluminescence method. Active oxygen generation and intracellular ATP content of PMNs were kept within only a few minutes in CAPD dialysate with pH 5.1. But, they were kept over one hour in CAPD dialysate with pH 7.4. Active oxygen generation of PMNs were kept in 1.5% CAPD dialysate (356 mOsm/l) better than 4.25% CAPD dialysate (499 mOsm/l). These results suggest the advantage of neutralized CAPD dialysate in peritonitis during CAPD.