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Title: Peritoneal dialysis fluid biocompatibility impact on human peritoneal membrane permeability
Authors: Rodríguez-Esparragón, Francisco 
Marrero-Robayna, Silvia
González-Cabrera, Fayna
Hernández-Trujillo, Yaridé
Buset-Ríos, Nisa
Rodríguez-Pérez, José Carlos 
Vega-Díaz, Nicanor 
UNESCO Clasification: 320506 Nefrología
Keywords: Bicarbonate/Lactate Buffered Solution
Epithelial-To-Mesenchymal Transition
Mesothelial Cells
Peritoneal Dialysis, et al
Issue Date: 2018
Journal: CKJ: Clinical Kidney Journal 
Abstract: Background. We have compared the effects of conventional lactate-based peritoneal dialysis fluid (CPDF) with respect to bicarbonate/lactate-based fluid on peritoneal ultrafiltration (UF) and peritoneal permeability, and on variations on gene expression in cells isolated from effluents of patients' peritoneal bags. Methods. This was a non-randomized sequential prospective study including all incident peritoneal dialysis (PD) patients (n ¼ 40) recruited in our centre. Peritoneal equilibration tests (PETs) were performed using CPDF or BPDF both containing 2.27% glucose during a 48-h interval in four different sequences. Gene expression variation of selected genes was measured by reverse transcription polymerase chain reaction in mesothelial cells obtained from the total drained fluid during the PET. Results. In the overall study, the use of BPDF was associated with significantly lower mass transfer area coefficient for urea and creatinine, longer accelerated peritoneal examination test times for urea and creatinine, lower total pore area available for exchange over diffusion distance and lower UF. There were no differences in the gene expression of aquaporins 1-3, endothelial and inducible nitric oxide synthase (NOS3 and NOS2), or interleukin-6. The SNAIL and E-CADHERIN gene expression normalized ratio was evaluated in peritoneal effluents of cells obtained from CPDF and BPDF. We observed that the SNAIL/E-CADHERIN mRNA ratio decreased when the dialysis sequence started with BPDF and went on to CPDF, but not when the sequence was the opposite. Conclusion. This study shows that those patients who started PD treatment with BPDF were characterized by a better biocompatibility profile. BPDF associates with lower peritoneal permeability to small molecules and lower UF.
ISSN: 2048-8505
DOI: 10.1093/ckj/sfy043
Source: Clinical Kidney Journa l[ISSN 2048-8505], v. 11 (6), p. 881-888
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