Reducing the formation of glucose degradation products in peritoneal dialysis solutions by ultrahigh temperature ohmic heating.

Peritoneal dialysis (PD) is commonly performed by using preprepared dialysis solutions containing glucose, which are thermally treated to achieve commercial sterilization. A series of glucose degradation products (GDPs) are being formed, which react with the tissue during the dialysis procedure, thus baring a negative effect on the patient and the dialysis process. The present study tested the efficacy of ohmic heating as an alternative thermal treatment for continuous sterilization of PD solutions. The process was compared to conventional retort treatment, and GDPs accumulation was measured. Thermal treatments using the ohmic heating system were performed at three temperatures (105, 125, and 150 degrees C) with residence time at each temperature ranging from 0.84 to 12.0 s. The resulting concentrations of glyoxal (GO), methylglyoxal (MGO), and 3-deoxyglucosone (3-DG) in the PD solutions were measured. None of these GDPs were found in PD fluids treated by ohmic heating at 105 degrees C. The concentration of 3-DG, after a standard sterilization treatment (121 degrees C, 20 or 40 min) was one order of magnitude higher (approximately 140 and 242 microM) than after ohmic heating treatment at 125 degrees C. The results of the present study suggest that this technique can be used to produce solutions with much lower content of GDPs. It also demonstrates the advantage of using the ohmic heating technology as a tool for high temperature short time treatment of PD fluids.