Effects of Low Glucose Degradation Products Peritoneal Dialysis Fluid on the Peritoneal Fibrosis and Vascularization in a Chronic Rat Model

: In the present study, we examined the effects of a new peritoneal dialysis fluid (PDF) with a low level of low glucose degradation products (GDP) on the functional and structural stability of the peritoneal membrane (PM). Male Sprague‐Dawley rats were divided into three groups: group C (n = 8), without dialysate infusion; group P (n = 12), infused with low‐level GDP solution (4.25% Physioneal, pH 7.0–7.4); and group D (n = 12), infused with conventional solution (4.25% Dianeal, pH 5.2, adjusted to pH 7.0). In groups D and P, animals were infused through a permanent catheter with 25 mL of PDF, twice daily for 8 weeks. Lipopolysaccharide was added into the PDF immediately before infusion on days 8, 9 and 10 in the two dialysis groups. When compared with group P, group D showed a higher glucose mass transfer at weeks 6 and 8, D/P urea at week 8, TGF‐β1 at weeks 4 and 8, and VEGF level at week 8. The submesothelial matrix layer of the parietal peritoneum was significantly thickened in group D and the lectin‐stained blood vessels in this layer were well‐visualized in group D compared with group P. There were significantly more peritoneal blood vessels in group D than group P. The transforming growth factor‐β induced gene‐h3 (βig‐h3) and TGF‐β1 levels in the peritoneal effluent correlated with the submesothelial thickness, which correlated with the dialysate‐to‐plasma ratio (D/P) of protein and, inversely, with the rate of glucose transport (D/D0 glucose, where D is glucose concentration in the dialysate and D0 is glucose concentration in the dialysis solution before it is infused into the peritoneal cavity). The present study showed that low‐GDP PDF effectively attenuated the peritoneal vascularization and fibrosis related to conventional solution.