Different effects of amino acid‐based and glucose‐based dialysate from peritoneal dialysis patients on mesothelial cell ultrastructure and function

Background. Peritoneal dialysis fluid (PDF) containing amino acids has been introduced recently aiming to improve the nutritional status of PD patients. Dextrose‐based PDFs have been implicated in progressive functional and structural deterioration of the peritoneal membrane. Limited data are currently available regarding the effect of amino acid‐based PDF on the function and ultrastructure of human peritoneal mesothelial cells (HPMCs), which play a critical role in peritoneal membrane pathophysiology. Methods. We investigated the effects of two commercially available PDFs, which utilized dextrose (1.5% Dianeal) or amino acids (1.1% Nutrineal) as the osmotic agent, obtained from patients after a 4 h dwell, on HPMC proliferation (MTT assay and cell counting) and viability [lactate dehydrogenase (LDH)release], interleukin‐6 (IL‐6) secretion (commercial enzyme‐linked immunosorbent assay) and ultrastructure (scanning and transmission electron microscopy). Results. Exposure of HPMCs to 1.5% Dianeal reduced cell proliferation, total cellular protein synthesis, IL‐6 secretion and cell attachment, but prolonged the cell doubling time on recovery, and increased LDH release (P