WCN26-3806 Report of laparoscopic findings in refractory peritonitis in peritoneal dialysis patients

Introduction:We previously reported temporary increase of eosinophils in peritoneal dialysis (PD) fluid (PDF) accompanied with elevation of C3a, a complement activation product, in pH-adjusted PDF with lactate buffer (L-PDF) overt half of patients during PD initiation period.Recently, pH-adjusted PDF with bicarbonate-based buffer was introduced in Japan.In the present study, we investigated effects of the different buffers for increase of eosinophils and the complement activation products in PDF during the initiation timing of PD.Methods: We compared effects of B-PDF (Reguneal LCa; group B) with L-PDF (Dianeal-N PD-4; group L); 28 patients on PD in group B who started PD in the University hospital and 28 patients from 2014 to 2016.Number of eosinophils, levels of the complement activation products, levels of IL-5 and IL-6 in PDF during overnight dwell were investigated on days 1, 2 and 4 after staring PD.As a reference, we used relevant data in 28 PD patients on PD with L-PDF (group L) in the previous report (Shigemoto E, et al.Perit Dial Int.2019) to compare each factor between groups B and L. We also analyzed between groups B and L in patients who started PD less than 30 days after PD catheter insertion (groups EB and EL, respectively).Results: Eosinophil counts was significantly correlated with C3a in PDF during the initiation periods.Increase of eosinophils was observed under usage of B-PDF as same as L-PDF after starting PD.When comparing between groups B and L, levels of IL-5 in PDF was significantly decreased in group B, but not eosinophils, IL-6, C3a, C5a, and sC5b-9.In contrast, number of eosinophils, levels of IL-5, C3a and sC5b-9 but not C5a, in PDF of group EB were significantly less than group EL on days 1, 2 and/or 4 after starting PD.Conclusion: From our results, increase of eosinophils in PDF was frequently observed when starting PD even if buffer in PDF was changed buffer in PDF from lactate to bicarbonate.However, compared with L-PDF, B-PDF might contribute to improve response of eosinophilia and the complement system when PD started less than 30 days after insertion of PD catheter.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.