Rapid and reliable measurement for evaluating directly the reactivity of N -acetylcysteine with glucose degradation products in peritoneal dialysis fluids

In this report, we analyzed the reactivity of N-acetyl-l-cysteine (NAC) with glucose degradation products (GDPs) and the stability of NAC in peritoneal dialysis fluids (PDFs) using RP-HPLC and LC-ESI-TOF-MS. NAC reduced the amount of 3,4-dideoxyglucosone-3-ene (3,4-DGE), most toxic among GDPs in PDFs by forming NAC-DGE conjugate under nonenzymatic conditions. NAC was retained as a reduced monomer form in the high-glucose compartment of dual-chambered neutral-pH type PDF, whereas it easily formed a homodimer in an incubation-time-dependent manner in other solutions. The present investigation suggests that NAC can be employed as an adjuvant added into the high-glucose compartment of neutral-pH type PDFs (N-PDF) to reduce GDP-mediated peritoneal membrane failure in patients on long-term peritoneal dialysis (PD) treatment.