Breborowicz A, Martis L, Oreopoulos D G
Department of Pathophysiology, Medical School Poznan, Poland.
Perit Dial Int. 1995;15(2):152-7.
To evaluate the changes in biocompatibility of peritoneal dialysis solutions during intraperitoneal dwell.
We studied the effect of the drained dialysates at time 0 and after 30, 60, 120, 240, and 360 minutes of intraperitoneal dwell on the growth of peritoneal mesothelial cells and fibroblasts and the synthesis of proteins by these cells. On one day the patients were dialyzed with glucose-based Dianeal and on alternate days with an amino acid-containing solution based on Travasol.
Dialysates were collected from 4 patients during continuous ambulatory peritoneal dialysis (CAPD) training.
Unused dialysis solutions containing glucose or amino acids inhibit growth of mesothelial cells and fibroblasts. Dialysates obtained after 30 or 60 minutes of intraperitoneal dwell support the growth of these cells in a way similar to 10% fetal calf serum, but dialysates drained after a longer dwell of 120-360 minutes had a stronger effect on growth of these cells than did serum. All glucose-based dialysates stimulate the synthesis of collagen in mesothelial cells, whereas they reduce the synthesis of non-collagen proteins. All glucose-based dialysates reduce the synthesis of collagen and non-collagen proteins in fibroblasts compared with the production of these proteins in the presence of serum.
Changes in the properties of the dialysis solutions during their intraperitoneal dwells do not seem to increase their biocompatibility. Indeed, excessive mitogenic effect and the stimulation of collagen synthesis of the dialysates may induce pathological changes in the peritoneum.
评估腹膜透析液在腹腔留置期间生物相容性的变化。
我们研究了腹腔留置0分钟、30分钟、60分钟、120分钟、240分钟和360分钟时引流的透析液对腹膜间皮细胞和成纤维细胞生长以及这些细胞蛋白质合成的影响。患者一天使用基于葡萄糖的百特腹膜透析液进行透析，隔天使用基于特拉万索尔的含氨基酸溶液进行透析。
在持续性非卧床腹膜透析（CAPD）培训期间从4名患者收集透析液。
未使用的含葡萄糖或氨基酸的透析液会抑制间皮细胞和成纤维细胞的生长。腹腔留置30或60分钟后获得的透析液以类似于10%胎牛血清的方式支持这些细胞的生长，但留置120 - 360分钟更长时间后引流的透析液对这些细胞生长的影响比血清更强。所有基于葡萄糖的透析液均刺激间皮细胞中胶原蛋白的合成，而它们会减少非胶原蛋白的合成。与在血清存在下这些蛋白质的产生相比，所有基于葡萄糖的透析液均减少成纤维细胞中胶原蛋白和非胶原蛋白的合成。
透析液在腹腔留置期间其性质的变化似乎并未增加其生物相容性。实际上，透析液过度的促有丝分裂作用和对胶原蛋白合成的刺激可能会诱导腹膜发生病理变化。
