1. Improved biocompatibility of bicarbonate/lactate-buffered PDF is not related to pH
- Author
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Eelco D. Keuning, Robert H.J. Beelen, Mohammad Zareie, Piet M. ter Wee, Casper G. Schalkwijk, Jacob van den Born, Groningen Kidney Center (GKC), and Groningen Institute for Organ Transplantation (GIOT)
- Subjects
medicine.medical_treatment ,Wistar ,Lactic Acid/pharmacology ,Chronic/diagnosis ,Dialysis Solutions/adverse effects ,Kidney Failure ,chemistry.chemical_compound ,Random Allocation ,Liver/drug effects ,Risk Factors ,Dialysis Solutions ,Statistics ,Hydrogen-Ion Concentration ,Kidney Failure, Chronic/diagnosis ,Lactic acid ,medicine.anatomical_structure ,Liver ,Nephrology ,Omentum/drug effects ,Peritoneum ,Omentum ,Peritoneal Dialysis ,medicine.medical_specialty ,Hydrochloride ,Peritoneal Dialysis/adverse effects ,Bicarbonate ,Buffers ,Sensitivity and Specificity ,Statistics, Nonparametric ,Peritoneal dialysis ,In vivo ,Internal medicine ,medicine ,Animals ,Nonparametric ,Lactic Acid ,Rats, Wistar ,Bicarbonates/pharmacology ,Probability ,Transplantation ,Osmotic concentration ,business.industry ,Animal ,Peritoneum/drug effects ,Rats ,body regions ,Ultrafiltration (renal) ,Bicarbonates ,Disease Models, Animal ,Endocrinology ,chemistry ,Disease Models ,Kidney Failure, Chronic ,business - Abstract
BACKGROUND: Chronic exposure to conventional peritoneal dialysis fluid (PDF) is associated with functional and structural alterations of the peritoneal membrane. The bioincompatibility of conventional PDF can be due to hypertonicity, high glucose concentration, lactate buffering system, presence of glucose degradation products (GDPs) and/or acidic pH. Although various investigators have studied the sole effects of hyperosmolarity, high glucose, GDPs and lactate buffer in experimental PD, less attention has been paid to the chronic impact of low pH in vivo.METHODS: Rats received daily 10 ml of either conventional lactate-buffered PDF (pH 5.2; n=7), a standard bicarbonate/lactate-buffered PDF with physiological pH (n=8), bicarbonate/lactate-buffered PDF with acidic pH (adjusted to pH 5.2 with 1 N hydrochloride, n=5), or bicarbonate/lactate buffer, without glucose, pH 7.4 (n=7). Fluids were instilled via peritoneal catheters connected to implanted subcutaneous mini vascular access ports for 8 weeks. Control animals with or without peritoneal catheters served as control groups (n=8/group). Various functional (2 h PET) and morphological/cellular parameters were analyzed.RESULTS: Compared with control groups and the buffer group, conventional lactate-buffered PDF induced a number of morphological/cellular changes, including angiogenesis and fibrosis in various peritoneal tissues (all parameters PCONCLUSION: The bicarbonate/lactate-buffered PDF, acidity per se did not contribute substantially to peritoneal worsening in our in vivo model for PD, which might be explained by the buffering capacity of the peritoneum.
- Published
- 2006