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Take care in how you store your PD fluids: Actual temperature determines the balance between reactive and non-reactive GDPs

In English

Författare

  • Martin Erixon
  • Anders Wieslander
  • Torbjörn Linden
  • Ola Carlsson
  • Gunita Forsbäck
  • Eva Svensson
  • Jan Åke Jönsson
  • Per Kjellstrand

Summary, in English

Objective: During heat sterilization and during prolonged storage, glucose in peritoneal dialysis fluids (PDF) degrades to carbonyl compounds commonly known as glucose degradation products (GDPs). Of these, 3,4-dideoxyglucosone-3-ene (3,4-DGE) is the most cytotoxic. It is an intermediate in degradation between 3-deoxyglucosone (3-DG) and 5-hydroxymethyl-2-furaldehyde (5-HMF). We have earlier reported that there seems to be equilibrium between these GDPs in PDF. The aim of the present study was to investigate details of this equilibrium. Methods: Aqueous solutions of pure 3-DG, 3,4-DGE, and 5-HMF were incubated at 40 degrees C for 40 days., Conventional and low-GDP fluids were incubated at various temperatures for up to, 3 weeks. Formaldehyde, acetaldehyde, glyoxal, methylglyoxal, 3-DG, 3,4-DGE, and 5-HMF were analyzed using high performance liquid chromatography. Results: Incubation of 100 mu mol/L 3,4-DGE resulted in the production of 36 mu mol/L 3-DG, 4 mu mol/L 5-HMF, and 40 mu mol/L unidentified substances. With the same incubation, 200 mu mol/L 3-DG was converted to 9 mu mol/L 3,4-DGE, 6 mu mol/L 5-HMF, and 14 mu mol/L unidentified substances. By contrast, 100 mu mol/L 5-HMF was uninfluenced by incubation. In a conventional PDF incubated at 60 degrees C for 1 day, the 3,4-DGE concentration increased from 14 to a maximum of 49 mu mol/L. When the fluids were returned to room temperature, the concentration decreased but did not reach original values until after 40 days. In a low GDP fluid, 3,4-DGE increased and decreased in the same manner as in the conventional fluid but reached a maximum of only 0.8 mu moL/L. Conclusions: Considerable amounts of 3,4-DGE maybe recruited by increases in temperature in conventional PDFs. Lowering the temperature will again reduce the concentration but much more time will be needed. Precursors for 3,4-DGE recruitment are most probably 3-DG and the enol 3-deoxyaldose-2-ene, but not 5-HMF. Considering the ease at which 3,4-DGE is recruited from its pool of precursors and the difficulty of getting rid of it again, one should be extremely careful with the temperatures conventional PDFs are exposed to.

Publiceringsår

2005

Språk

Engelska

Sidor

583-590

Publikation/Tidskrift/Serie

Peritoneal Dialysis International

Volym

25

Issue

6

Dokumenttyp

Artikel i tidskrift

Förlag

Multimed Inc.

Ämne

  • Urology and Nephrology

Nyckelord

  • GDPs
  • temperature
  • 4-DGE
  • 3
  • storage
  • glucose

Status

Published

ISBN/ISSN/Övrigt

  • ISSN: 1718-4304