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The in vitro toxicity of peritoneal dialysis fluid.

OBJECTIVE
To investigate the toxicity of peritoneal dialysis fluid (PDF) components on peritoneal changes in primary human mesothelial cell.


MATERIAL AND METHOD
To investigate the mechanism of changes, primary human peritoneal mesothelial cells (HPMCs) were isolated from human omental tissue and were exposed for 15 hours with the various concentrations of conventional PDF and various PDF components. The mesothelial injury was determined by calculating a ratio of supernatant and total intracellular LDH while mesothelial apoptosis was assessed and counted by positive TUNEL staining and flow cytometry, respectively.


RESULTS
PDF caused mesothelial detachment, de-differentiation, cell injuries, and apoptosis and this depended on the concentrations of PDF. The acidic condition and high glucose concentration likely played a major role in the HPMC injuries and detachment while individual PDF component could not yield mesothelial apoptosis as severe as the whole PDF effects. Thus, the additive effects of PDF composition, instead of the effect of each component, contributed to dialysis-related HPMC damages.


CONCLUSION
PDF showed concentration dependent fashion-induced HPMC injury, dedifferentiation, and apoptosis. All of the abnormalities occurred by the additive effects of PDF components.