Περίληψη:
At present, lactate is the most commonly used buffer in peritoneal
dialysis fluids (PDFs), The high lactate concentration in combination
with low original pH was demonstrated to suppress phagocytic function,
We evaluated the in vitro effects of a newly formulated
bicarbonate;buffered PDF containing glycylglycine (BiGG15 and BiGG40;
Pierre Fabre Medicament, Castres, France) on peritoneal macrophage (PM0)
function, and compared them with those of equiosmolar lactate-buffered
PDF (1.5% and 4.25% glucose; pH 5.4 and pH 7.4) and control buffer,
Peritoneal macrophages were isolated from the effluents of 10 continuous
ambulatory peritoneal dialysis patients and tested for luminol- and
lucigenin-enhanced chemiluminescence, superoxide (O-2(-)) generation
measured by cytochrome c reduction, killing capacity, and phagocytosis
after incubation in the PDF used, Exposure of PM0 to lactate-buffered
PDF with an original pH of 5.4 resulted in a significant suppression of
all PM0 functions measured, compared with bicarbonate- and
lactate-buffered PDFs with a pH of 7.4, At physiological pH (7.4),
chemiluminescence generation of PM0 exposed to BiGG15/40 was
significantly higher compared with the corresponding equiosmolar
lactate-buffered PDF (1,992 +/- 858 x 10(3) cpm/10(4) cells v 856 +/-
398 x 10(3) cpm/10(4) cells; P < 0.004), O-2(-) generation, killing
capacity, and phagocytosis were not significantly different after PM0
exposure to bicarbonate compared with exposure to lactate-buffered PDF
with a neutral pH, Irrespective of the buffer used, high-osmolality PDFs
suppressed PM0 function significantly more than low-osmolar PDFs, In
conclusion, bicarbonate-buffered PDFs are less detrimental to PM0)
function than lactate-containing PDFs; these preliminary in vitro
results need to be confirmed in vivo. (C) 1995 by the National Kidney
Foundation, Inc.
Συγγραφείς:
Fischer, FP
Schenk, U
Kiefer, T
Hubel, E
Thomas, S and
Yatzidis, H
Mettang, T
Kuhlmann, U
