Pyruvate anions neutralize peritoneal dialysate cytotoxicity

A new peritoneal dialysate containing pyruvate anions was developedin order to avoid cytotoxic effect of conventional lactate-baseddialysate. The dialysate has a final pH of 5.4 to 5.6 and iscomposed of 1.36–3.86% glucose-monohydrate; 132 mmol/lsodium; 1.75 mmol/l calcium; 0.75 mmol/l magnesium; 102 mmol/lchloride and 35 mmol/l pyruvate. For cytotoxicity testing peritonealmacrophages, and mesothelial cells (MC) were exposed to conventionallactate dialysate, and pyruvate dialysate. We investigated theO₂^– generation and cytokine synthesis after endotoxinstimulation in peritoneal macrophages and the proliferationof mesothelial cells of cultured human MC. After exposure tolactate dialysate O₂^– generation and cytokine synthesisin peritoneal macrophages and proliferation of mesothelial cellswere inhibited when compared to solution containing pyruvateand the control solution. After preincubation with 3.86% glucosecontaining solutions, all negative effects became even morepronounced in the lactate group whereas after pre-exposure topyruvate containing solution the toxic effects were absent.These results suggest that the acute toxic effects of commerciallyavailable peritoneal dialysates can be avoided by the use ofsodium pyruvate instead of sodium lactate.