COMPARISON OF COMPLEMENT ACTIVATION PRODUCTS IN PERITONEAL DIALYSIS (PD) FLUID IN PD PATIENTS DURING INTRODUCTION PERIODS BETWEEN BICARBONATE-BASED AND LACTATE-BASED PD SOLUTIONS.

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COMPARISON OF COMPLEMENT ACTIVATION PRODUCTS IN PERITONEAL DIALYSIS (PD) FLUID IN PD PATIENTS DURING INTRODUCTION PERIODS BETWEEN BICARBONATE-BASED AND LACTATE-BASED PD SOLUTIONS.

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Co-author 1

Masafumi Suzuki masa.sfc@med.nagoya-u.ac.jp Nagoya University Graduate School of Medicine Nephrology Nagoya Japan -

Co-author 2

Hangsoo Kim hangsoo.kim33@gmail.com Nagoya University Graduate School of Medicine Renal Replacement Therapy Nagoya Japan -

Co-author 3

Sosuke Fukui fukui22@med.nagoya-u.ac.jp Nagoya University Graduate School of Medicine Renal Replacement Therapy Nagoya Japan -

Co-author 4

Satoshi Ototake ototake26@med.nagoya-u.ac.jp Nagoya University Graduate School of Medicine Renal Replacement Therapy Nagoya Japan -

Co-author 5

Yasuhiro Suzuki suzuyasu11@gmail.com Nagoya University Graduate School of Medicine Renal Replacement Therapy Nagoya Japan -

Co-author 6

Shoichi Marumaya marus@med.nagoya-u.ac.jp Nagoya University Graduate School of Medicine Nephrology Nagoya Japan -

Co-author 7

Yasuhiko Ito yasuito@aichi-med-u.ac.jp Aichi Medical University Nephrology and Rheumatology Nagakute Japan -

Co-author 8

Masashi Mizuno mmizu@med.nagoya-u.ac.jp Nagoya University Graduate School of Medicine Renal Replacement Therapy Nagoya Japan *

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

We previously reported temporary increase of eosinophils in peritoneal dialysis (PD) fluid (PDF) accompanied with elevation of C3a, a complement activation product, in pH-adjusted PDF with lactate buffer (L-PDF) overt half of patients during PD initiation period. Recently, pH-adjusted PDF with bicarbonate-based buffer was introduced in Japan. In the present study, we investigated effects of the different buffers for increase of eosinophils and the complement activation products in PDF during the initiation timing of PD.

Methods

We compared effects of B-PDF (Reguneal LCa; group B) with L-PDF (Dianeal-N PD-4; group L); 28 patients on PD in group B who started PD in the University hospital and 28 patients from 2014 to 2016. Number of eosinophils, levels of the complement activation products, levels of IL-5 and IL-6 in PDF during overnight dwell were investigated on days 1, 2 and 4 after staring PD. As a reference, we used relevant data in 28 PD patients on PD with L-PDF (group L) in the previous report (Shigemoto E, et al. Perit Dial Int.2019) to compare each factor between groups B and L. We also analyzed between groups B and L in patients who started PD less than 30 days after PD catheter insertion (groups EB and EL, respectively).

Results

Eosinophil counts was significantly correlated with C3a in PDF during the initiation periods. Increase of eosinophils was observed under usage of B-PDF as same as L-PDF after starting PD. When comparing between groups B and L, levels of IL-5 in PDF was significantly decreased in group B, but not eosinophils, IL-6, C3a, C5a, and sC5b-9. In contrast, number of eosinophils, levels of IL-5, C3a and sC5b-9 but not C5a, in PDF of group EB were significantly less than group EL on days 1, 2 and/or 4 after starting PD.

Conclusion

From our results, increase of eosinophils in PDF was frequently observed when starting PD even if buffer in PDF was changed buffer in PDF from lactate to bicarbonate. However, compared with L-PDF, B-PDF might contribute to improve response of eosinophilia and the complement system when PD started less than 30 days after insertion of PD catheter.

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