Acute Exposure to Conventional Peritoneal Dialysis Fluids Does Not Alter the Hepatic Microcirculation

Peritioneal Dialysis (PD) has been associated with the development of structural and functional alterations of the peritoneal membrane and vasculature, including that of the liver. In this study, we investigated the contribution of pH buffers and glucose content of conventional PD fluids on the hepatic microvasculature. To determine whether acute exposure to a variety of PD solutions altered the hepatic inflammatory response, male C57BL/6 mice received TNF 500 ng intraperitoneally (IP) or 50 μl normal saline. At 3hrs, all mice received 2mL of one of eight PD fluids (IP), which varied in either sugar, concentration of sugar, or buffer. Controls received 2mL of lactated Ringer's. The hepatic microcirculation was examined at 1hr post‐PD by intravital microscopy. As expected, TNF‐treated mice showed significantly higher leukocyte recruitment as compared to controls in both post‐sinusoidal and sinusoidal venules (P<0.05). There was no significant difference in post‐sinusoidal rolling and adhesion or sinusoidal adhesion between any of the 8 PD fluids tested. White blood cells count did not differ significantly between all solutions (P<0.05). These data suggest that during an acute exposure to the tested PD fluids and with the variation in glucose content, sterilization and buffering methods, hepatic leukocyte‐endothelial cell interactions were not significantly altered. Importantly, these effects were also not seen when the hepatic microcirculation was stimulated with the cytokine TNF. Compared to our corresponding work in the peritoneal microcirculation the liver may require a longer exposure to PD fluids.