Top

Published in:

Open Access 01-06-2018 | Nephrology - Original Paper

Differences in peritoneal response after exposure to low-GDP bicarbonate/lactate-buffered dialysis solution compared to conventional dialysis solution in a uremic mouse model

Authors: M. Vila Cuenca, E. D. Keuning, W. Talhout, N. J. Paauw, F. J. van Ittersum, P. M. ter Wee, R. H. J. Beelen, M. G. Vervloet, E. Ferrantelli

Published in: International Urology and Nephrology | Issue 6/2018

Abstract

Background

Long-term exposure of conventional peritoneal dialysis (PD) fluid is associated with structural membrane alterations and technique failure. Previously, it has been shown that infiltrating IL-17-secreting CD4+T cells and pro-fibrotic M2 macrophages play a critical role in the PD-induced pathogenesis. Although more biocompatible PD solutions are recognized to better preserve the peritoneal membrane integrity, the impact of these fluids on the composition of the peritoneal cell infiltrate is unknown.

Materials and methods

In a uremic PD mouse model, we compared the effects of daily instillation of standard lactate (LS) or bicarbonate/lactate-buffered solutions (BLS) and respective controls on peritoneal fibrosis, vascularisation, and inflammation.

Results

Daily exposure of LS fluid during a period of 8 weeks resulted in a peritoneal increase of αSMA and collagen accompanied with new vessel formation compared to the BLS group. Effluent from LS-treated mouse showed a higher percentage of CD4⁺ IL-17⁺ cell population while BLS exposure resulted in an increased macrophage population. Significantly enhanced inflammatory cytokines such as TGFβ1, TNFα, INFγ, and MIP-1β were detected in the effluent of BLS-exposed mice when compared to other groups. Further, immunohistochemistry of macrophage subset infiltrates in the BLS group confirmed a higher ratio of pro-inflammatory M1 macrophages over the pro-fibrotic M2 subset compared to LS.

Conclusion

Development of the peritoneal fibrosis and angiogenesis was prevented in the BLS-exposed mice, which may underlie its improved biocompatibility. Peritoneal recruitment of M1 macrophages and lower number of CD4⁺ IL-17⁺ cells might explain the peritoneal integrity preservation observed in BLS-exposed mouse.

Devuyst O, Margetts PJ, Topley N (2010) The pathophysiology of the peritoneal membrane. J Am Soc Nephrol 21(7):1077–1085. https://doi.org/10.1681/ASN.2009070694 CrossRefPubMed

Schilte MN, Celie JW, Wee PM, Beelen RH, van den Born J (2009) Factors contributing to peritoneal tissue remodeling in peritoneal dialysis. Perit Dial Int 29(6):605–617PubMed

Pecoits-Filho R, Mujais S, Lindholm B (2002) Future of icodextrin as an osmotic agent in peritoneal dialysis. Kidney Int Suppl 62(81):S80–S87. https://doi.org/10.1046/j.1523-1755.62.s81.11.x

Hekking LH, Zareie M, Driesprong BA, Faict D, Welten AG, de Greeuw I, Schadee-Eestermans IL, Havenith CE, van den Born J, ter Wee PM, Beelen RH (2001) Better preservation of peritoneal morphologic features and defense in rats after long-term exposure to a bicarbonate/lactate-buffered solution. J Am Soc Nephrol 12(12):2775–2786PubMed

MacKenzie RK, Holmes CJ, Moseley A, Jenkins JP, Williams JD, Coles GA, Faict D, Topley N (1998) Bicarbonate/lactate- and bicarbonate-buffered peritoneal dialysis fluids improve ex vivo peritoneal macrophage TNFalpha secretion. J Am Soc Nephrol 9(8):1499–1506PubMed

Williams JD, Topley N, Craig KJ, Mackenzie RK, Pischetsrieder M, Lage C, Passlick-Deetjen J, Group EBT (2004) The Euro-Balance Trial: the effect of a new biocompatible peritoneal dialysis fluid (balance) on the peritoneal membrane. Kidney Int 66(1):408–418. https://doi.org/10.1111/j.1523-1755.2004.00747.x CrossRefPubMed

Johnson DW, Brown FG, Clarke M, Boudville N, Elias TJ, Foo MW, Jones B, Kulkarni H, Langham R, Ranganathan D, Schollum J, Suranyi MG, Tan SH, Voss D, bal ANZTI (2012) The effect of low glucose degradation product, neutral pH versus standard peritoneal dialysis solutions on peritoneal membrane function: the balANZ trial. Nephrol Dial Transplant 27(12):4445–4453. https://doi.org/10.1093/ndt/gfs314 CrossRefPubMedPubMedCentral

Szeto CC, Chow KM, Lam CW, Leung CB, Kwan BC, Chung KY, Law MC, Li PK (2007) Clinical biocompatibility of a neutral peritoneal dialysis solution with minimal glucose-degradation products-a 1-year randomized control trial. Nephrol Dial Transplant 22(2):552–559. https://doi.org/10.1093/ndt/gfl559 CrossRefPubMed

Lam D, Bargman JM (2013) Peritonitis in the patient on peritoneal dialysis: does the composition of the dialysis fluid make a difference? Clin J Am Soc Nephrol 8(9):1471–1473. https://doi.org/10.2215/CJN.07830713 CrossRefPubMedPubMedCentral

10.

Farhat K, Douma CE, Ferrantelli E, Ter Wee PM, Beelen RHJ, van Ittersum FJ (2017) Effects of conversion to a bicarbonate/lactate-buffered, neutral-pH, low-GDP PD regimen in prevalent PD: a 2-year randomized clinical trial. Perit Dial Int 37(3):273–282. https://doi.org/10.3747/pdi.2015.00031 CrossRefPubMed

11.

Rodrigues-Díez R, Aroeira LS, Orejudo M, Bajo MA, Heffernan JJ, Rodrigues-Díez RR, Rayego-Mateos S, Ortiz A, Gonzalez-Mateo G, López-Cabrera M, Selgas R, Egido J, Ruiz-Ortega M (2014) IL-17A is a novel player in dialysis-induced peritoneal damage. Kidney Int 86(2):303–315. https://doi.org/10.1038/ki.2014.33 CrossRefPubMed

12.

Habib SM, Abrahams AC, Korte MR, Zietse R, de Vogel LL, Boer WH, Dendooven A, Clahsen-van Groningen MC, Betjes MG (2015) CD4-positive T cells and M2 macrophages dominate the peritoneal infiltrate of patients with encapsulating peritoneal sclerosis. PLoS ONE 10(4):e0120174. https://doi.org/10.1371/journal.pone.0120174 CrossRefPubMedPubMedCentral

13.

Hu W, Jiang Z, Zhang Y, Liu Q, Fan J, Luo N, Dong X, Yu X (2012) Characterization of infiltrating macrophages in high glucose-induced peritoneal fibrosis in rats. Mol Med Rep 6(1):93–99. https://doi.org/10.3892/mmr.2012.890 PubMedCrossRef

14.

Ferrantelli E, Liappas G, Keuning ED, Vila Cuenca M, González-Mateo G, Verkaik M, López-Cabrera M, Beelen RH (2015) A novel mouse model of peritoneal dialysis: combination of uraemia and long-term exposure to PD fluid. Biomed Res Int 2015:106902. https://doi.org/10.1155/2015/106902 CrossRefPubMedPubMedCentral

15.

Ferrantelli E, Liappas G, Vila Cuenca M, Keuning ED, Foster TL, Vervloet MG, Lopéz-Cabrera M, Beelen RH (2016) The dipeptide alanyl-glutamine ameliorates peritoneal fibrosis and attenuates IL-17 dependent pathways during peritoneal dialysis. Kidney Int 89(3):625–635. https://doi.org/10.1016/j.kint.2015.12.005 CrossRefPubMed

16.

Glim JE, Beelen RH, Niessen FB, Everts V, Ulrich MM (2015) The number of immune cells is lower in healthy oral mucosa compared to skin and does not increase after scarring. Arch Oral Biol 60(2):272–281. https://doi.org/10.1016/j.archoralbio.2014.10.008 CrossRefPubMed

17.

Ghosn EE, Cassado AA, Govoni GR, Fukuhara T, Yang Y, Monack DM, Bortoluci KR, Almeida SR, Herzenberg LA (2010) Two physically, functionally, and developmentally distinct peritoneal macrophage subsets. Proc Natl Acad Sci USA 107(6):2568–2573. https://doi.org/10.1073/pnas.0915000107 CrossRefPubMedPubMedCentral

18.

Oh EJ, Ryu HM, Choi SY, Yook JM, Kim CD, Park SH, Chung HY, Kim IS, Yu MA, Kang DH, Kim YL (2010) Impact of low glucose degradation product bicarbonate/lactate-buffered dialysis solution on the epithelial-mesenchymal transition of peritoneum. Am J Nephrol 31(1):58–67. https://doi.org/10.1159/000256658 CrossRefPubMed

19.

Mortier S, Faict D, Schalkwijk CG, Lameire NH, De Vriese AS (2004) Long-term exposure to new peritoneal dialysis solutions: effects on the peritoneal membrane. Kidney Int 66(3):1257–1265. https://doi.org/10.1111/j.1523-1755.2004.00879.x CrossRefPubMed

20.

Stavenuiter AW, Schilte MN, Ter Wee PM, Beelen RH (2011) Angiogenesis in peritoneal dialysis. Kidney Blood Press Res 34(4):245–252. https://doi.org/10.1159/000326953 CrossRefPubMed

21.

Frazier-Jessen MR, Kovacs EJ (1993) Abdominal wall thickness as a means of assessing peritoneal fibrosis in mice. J Immunol Methods 162(1):115–121CrossRefPubMed

22.

Williams JD, Craig KJ, Topley N, Von Ruhland C, Fallon M, Newman GR, Mackenzie RK, Williams GT, Group PBS (2002) Morphologic changes in the peritoneal membrane of patients with renal disease. J Am Soc Nephrol 13(2):470–479PubMed

23.

Williams JD, Craig KJ, Topley N, Williams GT (2003) Peritoneal dialysis: changes to the structure of the peritoneal membrane and potential for biocompatible solutions. Kidney Int Suppl 63(84):S158–S161. https://doi.org/10.1046/j.1523-1755.63.s84.46.x CrossRef

24.

Duman S, Ozbek SS, Gunay ES, Bozkurt D, Asci G, Sipahi S, Kirçelli F, Ertilav M, Ozkahya M, Ok E (2007) What does peritoneal thickness in peritoneal dialysis patients tell us? Adv Perit Dial 23:28–33PubMed

25.

Mortier S, Faict D, Lameire NH, De Vriese AS (2005) Benefits of switching from a conventional to a low-GDP bicarbonate/lactate-buffered dialysis solution in a rat model. Kidney Int 67(4):1559–1565. https://doi.org/10.1111/j.1523-1755.2005.00237.x CrossRefPubMed

26.

González-Mateo GT, Fernández-Míllara V, Bellón T, Liappas G, Ruiz-Ortega M, López-Cabrera M, Selgas R, Aroeira LS (2014) Paricalcitol reduces peritoneal fibrosis in mice through the activation of regulatory T cells and reduction in IL-17 production. PLoS ONE 9(10):e108477. https://doi.org/10.1371/journal.pone.0108477 CrossRefPubMedPubMedCentral

27.

Lech M, Anders HJ (2013) Macrophages and fibrosis: How resident and infiltrating mononuclear phagocytes orchestrate all phases of tissue injury and repair. Biochim Biophys Acta 1832(7):989–997. https://doi.org/10.1016/j.bbadis.2012.12.001 CrossRefPubMed

28.

Bellón T, Martínez V, Lucendo B, del Peso G, Castro MJ, Aroeira LS, Rodríguez-Sanz A, Ossorio M, Sánchez-Villanueva R, Selgas R, Bajo MA (2011) Alternative activation of macrophages in human peritoneum: implications for peritoneal fibrosis. Nephrol Dial Transplant 26(9):2995–3005. https://doi.org/10.1093/ndt/gfq771 CrossRefPubMed

29.

Weiss L, Stegmayr B, Malmsten G, Tejde M, Hadimeri H, Siegert CE, Ahlmén J, Larsson R, Ingman B, Simonsen O, van Hamersvelt HW, Johansson AC, Hylander B, Mayr M, Nilsson PH, Andersson PO, De los Ríos T (2009) Biocompatibility and tolerability of a purely bicarbonate-buffered peritoneal dialysis solution. Perit Dial Int 29(6):647–655PubMed

30.

Martikainen TA, Teppo AM, Grönhagen-Riska C, Ekstrand AV (2005) Glucose-free dialysis solutions: inductors of inflammation or preservers of peritoneal membrane? Perit Dial Int 25(5):453–460PubMed

31.

Glim JE, Niessen FB, Everts V, van Egmond M, Beelen RH (2013) Platelet derived growth factor-CC secreted by M2 macrophages induces alpha-smooth muscle actin expression by dermal and gingival fibroblasts. Immunobiology 218(6):924–929. https://doi.org/10.1016/j.imbio.2012.10.004 CrossRefPubMed

32.

Sakaguchi S (2004) Naturally arising CD4 + regulatory t cells for immunologic self-tolerance and negative control of immune responses. Annu Rev Immunol 22:531–562. https://doi.org/10.1146/annurev.immunol.21.120601.141122 CrossRefPubMed

33.

Schilte MN, Loureiro J, Keuning ED, ter Wee PM, Celie JW, Beelen RH, van den Born J (2009) Long-term intervention with heparins in a rat model of peritoneal dialysis. Perit Dial Int 29(1):26–35PubMed

34.

Stavenuiter AW, Farhat K, Vila Cuenca M, Schilte MN, Keuning ED, Paauw NJ, ter Wee PM, Beelen RH, Vervloet MG (2015) Protective effects of paricalcitol on peritoneal remodeling during peritoneal dialysis. Biomed Res Int 2015:468574. https://doi.org/10.1155/2015/468574 PubMedPubMedCentralCrossRef

Title: Differences in peritoneal response after exposure to low-GDP bicarbonate/lactate-buffered dialysis solution compared to conventional dialysis solution in a uremic mouse model
Authors: M. Vila Cuenca
E. D. Keuning
W. Talhout
N. J. Paauw
F. J. van Ittersum
P. M. ter Wee
R. H. J. Beelen
M. G. Vervloet
E. Ferrantelli
Publication date: 01-06-2018
Publisher: Springer Netherlands
Published in: International Urology and Nephrology / Issue 6/2018
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-018-1872-3

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Differences in peritoneal response after exposure to low-GDP bicarbonate/lactate-buffered dialysis solution compared to conventional dialysis solution in a uremic mouse model

Abstract

Background

Materials and methods

Results

Conclusion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2018

Diversity of the midstream urine microbiome in adults with chronic kidney disease

The importance of Oxalobacter formigenes and oxalic acid in the pathogenesis of chronic kidney disease

Comparative efficacy of pharmacological interventions for contrast-induced nephropathy prevention after coronary angiography: a network meta-analysis from randomized trials

Benefit of an operating vehicle preventing peritonitis in peritoneal dialysis patients: a retrospective, case–controlled study

Usefulness of personalized three-dimensional printed model on the satisfaction of preoperative education for patients undergoing robot-assisted partial nephrectomy and their families

Astaxanthin attenuates contrast agent-induced acute kidney injury in vitro and in vivo via the regulation of SIRT1/FOXO3a expression

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page