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PD fluids contain high concentrations of cytotoxic GDPs directly after sterilization

Erixon, Martin LU ; Lindén, Torbjörn; Kjellstrand, Per; Carlsson, Ola LU ; Ernebrant, Malin; Forsbäck, Gunita; Wieslander, Anders and Jönsson, Jan Åke LU (2004) In Peritoneal Dialysis International 24(4). p.392-398
Abstract
Objective: Glucose degradation products (GDPs) in peritoneal dialysis (PD) fluids are cytotoxic and affect the survival of the peritoneal membrane. One of the most reactive GDPs in PD fluids is 3,4-dideoxyglucosone-3-ene (3,4-DGE). 3,4-DGE has been reported as an intermediate between 3-deoxyglucosone (3-DG) and 5-hydroxymethyl furaldehyde (5-HMF) during degradation of glucose. In PD fluids, 3,4-DGE exists in a temperature-dependent equilibrium with a pool of unidentified substances. The aim of this study was to explore this equilibrium and its temperature dependence during the first months of storage after the sterilization procedure.



Methods: GDPs and inhibition of cell growth (ICG) were measured directly after... (More)
Objective: Glucose degradation products (GDPs) in peritoneal dialysis (PD) fluids are cytotoxic and affect the survival of the peritoneal membrane. One of the most reactive GDPs in PD fluids is 3,4-dideoxyglucosone-3-ene (3,4-DGE). 3,4-DGE has been reported as an intermediate between 3-deoxyglucosone (3-DG) and 5-hydroxymethyl furaldehyde (5-HMF) during degradation of glucose. In PD fluids, 3,4-DGE exists in a temperature-dependent equilibrium with a pool of unidentified substances. The aim of this study was to explore this equilibrium and its temperature dependence during the first months of storage after the sterilization procedure.



Methods: GDPs and inhibition of cell growth (ICG) were measured directly after sterilization of the PD fluid and during storage at different temperatures for 60 days. The following GDPs were analyzed: 3-DG, 3,4-DGE, 5-HMF, formaldehyde, acetaldehyde, glyoxal, and methylglyoxal.



Results: Immediately after sterilization, the concentration of 3,4-DGE was 125 mumol/L. During the first weeks of storage, it decreased by about 80%. At the same time, the 3-DG concentration increased. None of the other GDPs were significantly affected. Cytotoxicity correlated well with the concentration of 3,4-DGE. When pure 3,4-DGE was substituted for the lost amount of 3,4-DGE after 30 days of storage, the initial ICG was almost completely regained.



Conclusions: Heat sterilization of PD fluids promotes the formation of large quantities of 3,4-DGE, rendering the fluid highly cytotoxic. During storage, the main part of 3,4-DGE is reversibly converted in a temperature-dependent manner to a less cytotoxic pool, consisting mainly of 3-DG. Cytotoxicity seems to be dependent exclusively on 3,4-DGE. In order to avoid higher levels of 3,4-DGE concentrations, PD fluids should not be used too soon after sterilization and should not be stored at temperatures above room temperature. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
glucose, storage, 3, cytotoxicity, sterilization, 4-DGE
in
Peritoneal Dialysis International
volume
24
issue
4
pages
392 - 398
publisher
Multimed Inc.
external identifiers
  • wos:000223443600016
  • scopus:4444286745
ISSN
1718-4304
language
English
LU publication?
yes
id
6a5e93cf-f6dc-4097-a75c-43f2cad51802 (old id 127704)
alternative location
http://www.ncbi.nlm.nih.gov/sites/entrez
date added to LUP
2007-06-26 15:33:29
date last changed
2017-01-01 06:40:21
@article{6a5e93cf-f6dc-4097-a75c-43f2cad51802,
  abstract     = {Objective: Glucose degradation products (GDPs) in peritoneal dialysis (PD) fluids are cytotoxic and affect the survival of the peritoneal membrane. One of the most reactive GDPs in PD fluids is 3,4-dideoxyglucosone-3-ene (3,4-DGE). 3,4-DGE has been reported as an intermediate between 3-deoxyglucosone (3-DG) and 5-hydroxymethyl furaldehyde (5-HMF) during degradation of glucose. In PD fluids, 3,4-DGE exists in a temperature-dependent equilibrium with a pool of unidentified substances. The aim of this study was to explore this equilibrium and its temperature dependence during the first months of storage after the sterilization procedure.<br/><br>
<br/><br>
Methods: GDPs and inhibition of cell growth (ICG) were measured directly after sterilization of the PD fluid and during storage at different temperatures for 60 days. The following GDPs were analyzed: 3-DG, 3,4-DGE, 5-HMF, formaldehyde, acetaldehyde, glyoxal, and methylglyoxal.<br/><br>
<br/><br>
Results: Immediately after sterilization, the concentration of 3,4-DGE was 125 mumol/L. During the first weeks of storage, it decreased by about 80%. At the same time, the 3-DG concentration increased. None of the other GDPs were significantly affected. Cytotoxicity correlated well with the concentration of 3,4-DGE. When pure 3,4-DGE was substituted for the lost amount of 3,4-DGE after 30 days of storage, the initial ICG was almost completely regained.<br/><br>
<br/><br>
Conclusions: Heat sterilization of PD fluids promotes the formation of large quantities of 3,4-DGE, rendering the fluid highly cytotoxic. During storage, the main part of 3,4-DGE is reversibly converted in a temperature-dependent manner to a less cytotoxic pool, consisting mainly of 3-DG. Cytotoxicity seems to be dependent exclusively on 3,4-DGE. In order to avoid higher levels of 3,4-DGE concentrations, PD fluids should not be used too soon after sterilization and should not be stored at temperatures above room temperature.},
  author       = {Erixon, Martin and Lindén, Torbjörn and Kjellstrand, Per and Carlsson, Ola and Ernebrant, Malin and Forsbäck, Gunita and Wieslander, Anders and Jönsson, Jan Åke},
  issn         = {1718-4304},
  keyword      = {glucose,storage,3,cytotoxicity,sterilization,4-DGE},
  language     = {eng},
  number       = {4},
  pages        = {392--398},
  publisher    = {Multimed Inc.},
  series       = {Peritoneal Dialysis International},
  title        = {PD fluids contain high concentrations of cytotoxic GDPs directly after sterilization},
  volume       = {24},
  year         = {2004},
}