Ukr.Biochem.J. 2018; Том 90, № 2, березень-квітень, c. 34-44

doi: https://doi.org/10.15407/ubj90.02.034

Biological and analytical studies of peritoneal dialysis solutions

N. Hudz1, L. Kobylinska1, N. Dmytrukha2, R. Korytniuk3, P.P. Wieczorek4

1Danylo Halytsky Lviv National Medical University, Ukraine;
e-mail: natali_gudz@ukr.net;
2SI “Institute for Occupational Health of National Academy of Medical Sciences of Ukraine”, Kyiv;
3Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine;
4University of Opole, Poland

The purpose of our work was to conduct biological and analytical studies of the peritoneal dialysis (PD) solutions containing glucose and sodium lactate and establish correlations between cell viability of the Vero cell line and values of analytical indexes of the tested solutions. The results of this study confirm the cytotoxicity of the PD solutions even compared with the isotonic solution of sodium chloride, which may be due to the low pH of the solutions, presence of glucose degradation products (GDPs) and high osmolarity of the solutions, and unphysiological concentrations of glucose and sodium lactate. However, it is not yet known what factors or their combination and to what extent cause the cytotoxicity of PD solutions. In the neutral red (NR) test the weak, almost middle (r = -0.496 and 0.498, respectively) and unexpected correlations were found between reduced viability of monkey kidney cells and increased pH of the PD solutions and between increased cell viability and increased absorbance at 228 nm of the tested PD solutions. These two correlations can be explained by a strong correlation (r = -0.948) between a decrease in pH and an increase in the solution absorbance at 228 nm. The opposite effect was observed in the MTT test. The weak, but expected correlations (r = 0.32 and -0.202, respectively) were found between increased cell viability and  increased pH in the PD solutions and between decreased cell viability and increased absorbance at 228 nm of the tested PD solutions. The middle and weak correlations (r = 0.56 and 0.29, respectively) were detected between increased cell viability and increased lactate concentration in the NR test and MTT test. The data of these correlations can be partially explained by the fact that a correlation with a coefficient r = -0.34 was found between decreased pH in the solutions and increased lactate concentration. The very weak correlations (0.138 and 0.196, respectively) were found between increased cell viability and increased glucose concentration in the NR test and MTT test. These experimental data indicate that pH is the dominating factor, which determines almost all of the established correlations. However, the character of the correlations is quite different: the higher the pH, the greater was the cell viability in the MTT test, and conversely, the higher the pH, the lower was the cell viability in the NR test. Secondly, the unexpected correlation coefficient was determined as -0.473 between decreased cell viability in the MTT test and increased cell viability in the NR test. Moreover, this phenomenon indicates that the mitochondrial enzyme succinate dehydrogenase is more vulnerable to the action of PD solutions than membrane permeability. Finally, we conclude that the NR test is not suitable for comparative studies of PD solutions which differ in pH, as it is pH dependent and does not enable the comparison of plausible cell viability.

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Посилання:

  1. Yu X, Mehrotra R, Yang X. Components of A Successful Peritoneal Dialysis Program. Semin Nephrol. 2017 Jan;37(1):10-16. PubMed, CrossRef
  2. Li PK, Kwong VW. Current Challenges and Opportunities in PD. Semin Nephrol. 2017 Jan;37(1):2-9. PubMed, CrossRef
  3. Schmitt CP, Aufricht C. Is there such a thing as biocompatible peritoneal dialysis fluid? Pediatr Nephrol. 2017 Oct;32(10):1835-1843. PubMed, PubMedCentral, CrossRef
  4. Saidakova N., Kozlyuk N., Nikolaenko S., Stepanova N.  Peritoneal dialysis in Ukraine: 2009-2013. Ukr J Nephrol Dialysis. 2014;(4): 21-30.
  5. Cho Y, Johnson DW, Badve SV, Craig JC, Strippoli GF, Wiggins KJ.  The impact of neutral-pH peritoneal dialysates with reduced glucose degradation products on clinical outcomes in peritoneal dialysis patients. Kidney Int. 2013 Nov;84(5):969-79. PubMed, CrossRef
  6. Erixon M, Lindén T, Kjellstrand P, Carlsson O, Ernebrant M, Forsbäck G, Wieslander A, Jönsson JA. PD fluids contain high concentrations of cytotoxic GDPs directly after sterilization. Perit Dial Int. 2004 Jul-Aug;24(4):392-8. PubMed
  7. Erixon M, Wieslander A, Lindén T, Carlsson O, Forsbäck G, Svensson E, Jönsson JA, Kjellstrand P. Take care in how you store your PD fluids: actual temperature determines the balance between reactive and non-reactive GDPs. Perit Dial Int. 2005 Nov-Dec;25(6):583-90. PubMed
  8. Diaz-Buxo JA, Sawin DA, Himmele R. PD solutions: new and old. Dial Transplant. 2011; 40(8):356–363.   CrossRef
  9. Hanrahan CT, Himmele R, Diaz-Buxo JA. The challenges of heat sterilization of peritoneal dialysis solutions: is there an alternative? Adv Perit Dial. 2012;28:126-30. PubMed
  10. Hudz N. I. Spectrophotometric analysis in the development of peritoneal dialysis solutions. Vestnik Pharmacii. 2015; 70(4):63-70. (In Russian).
  11. Haybrard J, Simon N, Danel C, Pinçon C, Barthélémy C, Tessier FJ, Décaudin B, Boulanger E, Odou P. Factors generating glucose degradation products in sterile glucose solutions for infusion: statistical relevance determination of their impacts. Sci Rep. 2017 Sep 20;7(1):11932. PubMed, PubMedCentral, CrossRef
  12. British Pharmacopoeia. Edition 2009, Publisher London: The Stationery Office: 2009, 10952 p.
  13. Noh H, Kim JS, Han KH, Lee GT, Song JS, Chung SH, Jeon JS, Ha H, Lee HB. Oxidative stress during peritoneal dialysis: implications in functional and structural changes in the membrane. Kidney Int. 2006 Jun;69(11):2022-8. PubMed, CrossRef
  14. Andrusev AM. Peritoneal dialysis: long-term results, their determinants, and clinical pathophysiology. Nephrol Dialysis. 2005; 7(2):110-129. (In Russian).
  15. Distler L, Georgieva A, Kenkel I, Huppert J, Pischetsrieder M. Structure- and concentration-specific assessment of the physiological reactivity of α-dicarbonyl glucose degradation products in peritoneal dialysis fluids. Chem Res Toxicol. 2014 Aug 18;27(8):1421-30. PubMed,CrossRef
  16. Florento L, Matias R, Tuaño E, Santiago K, Dela Cruz F, Tuazon A. Comparison of Cytotoxic Activity of Anticancer Drugs against Various Human Tumor Cell Lines Using In Vitro Cell-Based Approach. Int J Biomed Sci. 2012 Mar;8(1):76-80. PubMed, PubMedCentral
  17. Repetto G, del Peso A, Zurita JL. Neutral red uptake assay for the estimation of cell viability/cytotoxicity. Nat Protoc. 2008;3(7):1125-31. PubMed, CrossRef
  18. Hudz N, Filipska A. Elements of standardization and quality control of laboratory batches of peritoneal dialysis solutions containing dextrose and sodium lactate. ScienceRise: Pharmaceutical Sci. 2017;(1): 4-12 (In Ukrainian). CrossRef
  19. Achim Bühl, Peter Zöfel. SPSS Version 10. Einführung in die modern Datenanalyse unter Windows, 7, überarbeitete und erweiterte Auflage, Diasoft: 2005, 602 p. (In Russian).
  20. Kjellstrand P, Erixon M, Wieslander A, Lindén T, Martinson E. Temperature: the single most important factor for degradation of glucose fluids during storage. Perit Dial Int. 2004 Jul-Aug;24(4):385-91. PubMed

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