Cytotoxicity of peritoneal dialysis fluid—is it related to glucose breakdown products?

In the winter of 1962-63 bee-keepers in England lost many colonies fed with commercial food candies. These food candies were composed of sucrose hydrolyzed by heat and acid instead of enzymes. It was later demonstrated that caged bees fed on the same type of commercial candy died within a few days. A higher percent of those bees fed on the darkest varieties of the candy died more quickly. It was concluded that the bees had died because of some unknown substance related to the heat induced decomposition of the glucose [1]. This report is only one of many, demonstrating toxicity due to break-down products of carbohydrates. Actually, one of the first reports, published in 1887 demonstrates that a bacterial medium exposed to sunlight kills bacterial spores as a consequence of changes in the carbohydrate fraction [2]. A later report, from 1935, demonstrates that after exposure to UV radiation several different carbohydrates prevent the growth of bacteria due to the formation of non-volatile and thermostable substances [3]. Among the carbohydrates investigated in this study were glucose and dextrin, two carbohydrates which are used as osmotic agents in fluids for peritoneal dialysis. The side-effects of carbohydrate degradation products have also been described for many mammalian cellular systems.