Low-calcium peritoneal dialysis fluid should not impact peritonitis rates in continuous ambulatory peritoneal dialysis

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
C W de FijterH A Verbrugh

Abstract

It has been suggested that reducing the calcium content of peritoneal dialysis fluid (PDF) to 2.5 mEq/L decreases peritoneal macrophage (PMO) function and increases the incidence of peritonitis (especially Staphylococcus epidermidis peritonitis) in continuous ambulatory peritoneal dialysis patients. We studied the uptake and killing of S epidermidis and Escherichia coli by PMOs and peripheral blood leukocytes incubated in control buffer (Hank's balanced salt solution containing 0.1% gelatin [GHBSS]) and PDF containing varying concentrations of calcium (O to 3.5 mEq/L) and magnesium (O to 1.5 mEq/L) using ether diamine tetraacetic acid and ethylenediaminetetraacetic acid chelation, respectively. In addition, interleukin-1-beta-induced interleukin-6 production by human mesothelial cells was measured in the presence of concentrations of calcium increasing from 0 to 3.0 mmol/L. Fc receptor- mediated uptake of S epidermidis by PMO in the complete absence of Ca++ was comparable to that by PMO incubated in GHBSS with calcium. In contrast, the complement-dependent uptake of E coli was significantly lower in GHBSS devoid of Ca++ (46% +/- 5% v 24% +/- 3%; 0.05 < P < 0.02). No effect on intracellular killing of either microorganism by PMO...Continue Reading

Citations

May 5, 2010·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Charles J Diskin
Jan 6, 2000·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·R K MackenzieN Topley

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