Effects of Icodextrin and Glucose Bicarbonate/Lactate-Buffered Peritoneal Dialysis Fluids on Effluent Cell Population and Biocompatibility Markers IL-6 and CA125 in Incident Peritoneal Dialysis Patients
Language English Country Australia Media print-electronic
Document type Journal Article
- Keywords
- Biocompatibility, Cancer antigen 125, Icodextrin interleukin-6, Peritoneal dialysis,
- MeSH
- CA-125 Antigen metabolism MeSH
- Dialysis Solutions chemistry MeSH
- Adult MeSH
- Glucans chemistry MeSH
- Glucose chemistry MeSH
- Bicarbonates chemistry MeSH
- Icodextrin MeSH
- Interleukin-6 metabolism MeSH
- Lactates chemistry MeSH
- Middle Aged MeSH
- Humans MeSH
- Peritoneal Dialysis methods MeSH
- Leukocyte Count MeSH
- Prospective Studies MeSH
- Flow Cytometry MeSH
- Aged MeSH
- Inflammation MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- CA-125 Antigen MeSH
- Dialysis Solutions MeSH
- Glucans MeSH
- Glucose MeSH
- Bicarbonates MeSH
- Icodextrin MeSH
- Interleukin-6 MeSH
- Lactates MeSH
Icodextrin peritoneal dialysis (PD) solution has been shown to increase interleukin-6 (IL-6) levels in PD effluent as well as leukocyte and mesothelial cell count. Mesothelial cells release cancer antigen 125 (CA125), which is used as a marker of mesothelial cell mass. This 1-year prospective study was designed to compare peritoneal effluent cell population, its inflammatory phenotype and biocompatibility biomarkers IL-6 and CA125 between icodextrin (E) and glucose bicarbonate/lactate (P) based PD solutions. Using baseline peritoneal ultrafiltration capacity, 19 stable incident PD patients were allocated either to P only (N = 8) or to P plus E for the overnight dwell (N = 11). Flow cytometry was used to measure white blood cell count and differential and the expression of inflammatory molecules on peritoneal cells isolated from timed overnight peritoneal effluents. Compared to P, E effluent showed higher leukocyte (10.9 vs. 7.9), macrophages (6.1 vs. 2.5) and mesothelial cells (0.3 vs. 0.1)×10(6) /L count, as well as expression of HLA DR on mesothelial cells and IL-6 (320.5 vs. 141.2 pg/min) on mesothelial cells and CA125 appearance rate (159.6 vs. 84.3 IU/min), all P < 0.05. In the E group, correlation between IL-6 and CA125 effluent levels (r = 0.503, P < 0.05) as well as appearance rates (r = 0.774, P < 0.001) was demonstrated. No effect on systemic inflammatory markers or peritoneal permeability was found. Icodextrin PD solution activates local inflammation without systemic consequences so the clinical relevance of this observation remains obscure. Correlation between effluent IL-6 and CA125 suggests that CA125 might be upregulated due to inflammation and thus is not a reliable marker of mesothelial cell mass and/or biocompatibility.
Biochemistry Charles University Medical School and Teaching Hospital Plzen Plzen Czech Republic
Biomedical Centre Faculty of Medicine in Plzen Charles University Prague Plzen Czech Republic
Hematooncology Charles University Medical School and Teaching Hospital Plzen Plzen Czech Republic
Nuclear Medicine Charles University Medical School and Teaching Hospital Plzen Plzen Czech Republic
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