The In vitro Toxicity of Peritoneal Dialysis Fluid
Wasin Manuprasert MSc*, Sirigul Kanchanabuch MSc*, Somchai Eiam-Ong MD**, Talerngsak Kanjanabuch MD*,**
Affiliation : * Kidney Ureter Bladder & Metabolic Disorder Research Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ** Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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.
Keywords : Peritoneal dialysis fluid, Apoptosis, Glucose, Mesothelial cells
