In the past, we had observed that infusion of
normal saline into the peritoneal cavity stimulates an inflammatory response. In the present study, we examined what effect the addition of
glucose to
normal saline would have on the peritoneal inflammatory response and change in peritoneal morphology. After
catheter implantation, rats were infused intraperitoneally (i.p.) for 3 days with Dianeal 1.36% (Baxter Healthcare Corporation, Deerfield, IL, U.S.A.).
Dialysate samples were collected on day 3 after a 4-hour dwell. Next, rats were exposed to either NaCl (n = 7) or NaCl with
glucose 250 mmol/L (Glu, n = 7) twice daily for 4 weeks. After 2 weeks and 4 weeks of the study,
dialysate samples were collected after a 4-hour dwell to analyze the activity of inflammatory reaction. At the end of the experiment, imprints of peritoneal mesothelium were taken. Control animals (C, n = 6) did not undergo
catheter implantation or the dialysis procedure. The inflammatory reaction--cell count, cell differentiation,
nitric oxide production,
protein loss, and
monocyte chemoattractant protein-1 (MCP-1) concentration in
dialysate expressed as a percentage of the initial value--did not change during the study in rats exposed to NaCl. On the other hand, in Glu-treated animals, the
protein concentration was decreased after 4 weeks of the study (74% +/- 23%, p < 0.05), as was MCP-1 (24% +/- 12%, p < 0.05). The
nitrites concentration was decreased after 2 weeks (72% +/- 19%; p < 0.05). Intraperitoneal adhesions were found in 6 rats of the NaCl group (86%) and in only 4 rats (57%) of Glu group. In the NaCl rats, a higher density of mesothelial cells was observed (2792 +/- 510 cells/mm2) as compared with Glu rats (2028 +/- 561 cells/mm2; p < 0.05) and with control rats (1629 +/- 422 cells/mm2, p < 0.05). The NaCl group also showed a higher nucleus: cytoplasm surface ratio (0.25 +/- 0.03) as compared with the Glu group (0.18 +/- 0.02, p < 0.01) and with the control group (0.14 +/- 0.01, p < 0.01). Addition of
glucose to
normal saline suppresses the peritoneal inflammatory response and mesothelial
hyperplasia occurring with
intraperitoneal infusion of NaCl
solution alone.