scholarly journals An experimental, non-uremic rabbit model of peritoneal dialysis

2008 ◽  
pp. 253-260
Author(s):  
S Zunic-Bozinovski ◽  
Z Lausevic ◽  
S Krstic ◽  
N Jovanovic ◽  
J Trbojevic-Stankovic ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Rabbit Model ◽  
Peritoneal Membrane ◽  
Experimental Procedure ◽  
Long Term Effect ◽  
Catheter Obstruction ◽  
Dialysis Solutions ◽  
Dialysis Fluids ◽  
Infusion System

Peritoneal dialysis (PD) is a well established method of depuration in uremic patients. Standard dialysis solutions currently in use are not biocompatible with the peritoneal membrane. Studying effects of dialysate on peritoneal membrane in humans is still a challenge. There is no consensus on the ideal experimental model so far. We, therefore, wanted to develop a new experimental non-uremic rabbit model of peritoneal dialysis, which would be practical, easy to conduct, not too costly, and convenient to investigate the long-term effect of dialysis fluids. The study was done on 17 healthy Chinchilla male and female rabbits, anesthetized with Thiopental in a dose of 0.5 mg/kg body mass. A catheter, specially made from Tro-soluset (Troge Medical GMBH, Hamburg, Germany) infusion system, was then surgically inserted and tunneled from animals' abdomen to their neck. The planned experimental procedure was 4 weeks of peritoneal dialysate instillation. The presented non-uremic rabbit model of peritoneal dialysis is relatively inexpensive, does not require sophisticated technology and was well tolerated by the animals. Complications such as peritonitis, dialysis fluid leakage, constipation and catheter obstruction were negligible. This model is reproducible and can be used to analyze the effects of different dialysis solutions on the rabbit peritoneal membrane.

scholarly journals Long-term exposure to new peritoneal dialysis solutions: Effects on the peritoneal membrane

2004 ◽  
Vol 66 (3) ◽  
pp. 1257-1265 ◽  
Author(s):  
Siska Mortier ◽  
Dirk Faict ◽  
Casper G. Schalkwijk ◽  
Norbert H. Lameire ◽  
A.N.S. De Vriese
Keyword(s):  
Peritoneal Dialysis ◽  
Peritoneal Membrane ◽  
Dialysis Solutions ◽  
Peritoneal Dialysis Solutions

scholarly journals Modification of peritoneal dialysis model on rabbits: A pilot study

2008 ◽  
Vol 136 (Suppl. 1) ◽  
pp. 38-43
Author(s):  
Snezana Zunic-Bozinovski ◽  
Biljana Stojimirovic ◽  
Zeljko Lausevic ◽  
Slobodan Krstic ◽  
Jasna Trbojevic-Stankovic ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Pilot Study ◽  
Recovery Period ◽  
Rabbit Model ◽  
Experimental Period ◽  
Experimental Models ◽  
Peritoneal Membrane ◽  
Long Term Effects ◽  
Peritoneal Tissue

INTRODUCTION. Long-term peritoneal dialysis, a well-established method of depuration in end-stage renal disease patients, is assosiated with morphological and functional alterations of the peritoneal membrane due to the use of bioincompatible dialysis solutions. Studying effects of dialysate on the peritoneal tissue in humans is still a challenge due to ethical and technical limitations. There has been a variety of peritoneal dialysis experimental models but without consensus on the ideal model so far. OBJECTIVE. We aimed to develop a new, modified experimental rabbit model of peritoneal dialysis which would be practical, easy to conduct, relatively inexpensive and convenient to study long-term effects of dialysis solution on the peritoneal membrane. METHOD. This pilot study was performed on five healthy Chinchilla rabbits of both sexes. After i.v. Thiopental injection BP 1G, 0.5 ml/kg body mass, a catheter, especially made from Tro-soluset (Troge Medical GmbH, Hamburg, Germany) infusion system, was surgically tunneled from the animals? neck to the abdomen and inserted to the bottom of the peritoneal cavity. After one week recovery period, peritoneal dialysate instillations were performed for four weeks. During the whole five week experimental period a follow-up diary was kept. RESULTS. All procedures were well tolerated by the animals. The rabbits gained body weight, had normal body temperature and no complications were noted. CONCLUSION. The presented modified peritoneal dialysis model is practical, reproducible, does not require sophisticated technology and is well tolerated by the animals. That is why it is convenient for studying long-term effects of dialysate on the rabbit?s peritoneal membrane.

Effects of Peritoneal Dialysis Solutions on the Peritoneal Membrane: Clinical Consequences

2005 ◽  
Vol 25 (3_suppl) ◽  
pp. 31-34 ◽  
Author(s):  
Janusz Witowski ◽  
Achim Jörres
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Significance ◽  
Peritoneal Membrane ◽  
Clinical Consequences ◽  
Dialysis Solutions ◽  
Dialysis Fluids ◽  
Peritoneal Dialysis Solutions

This review provides an overview of recent studies that show the clinical significance of biocompatibility of peritoneal dialysis fluids.

scholarly journals Unfavorable Effects of Peritoneal Dialysis Solutions on the Peritoneal Membrane: The Role of Oxidative Stress

Biomolecules ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 768
Author(s):  
Stefanos Roumeliotis ◽  
Evangelia Dounousi ◽  
Marios Salmas ◽  
Theodoros Eleftheriadis ◽  
Vassilios Liakopoulos
Keyword(s):  
Oxidative Stress ◽  
Peritoneal Dialysis ◽  
Peritoneal Membrane ◽  
Peritoneal Fibrosis ◽  
Structural Alterations ◽  
And Function ◽  
Dialysis Solutions ◽  
Harmful Effects

One of the main limitations to successful long-term use of peritoneal dialysis (PD) as a renal replacement therapy is the harmful effects of PD solutions to the structure and function of the peritoneal membrane (PM). In PD, the PM serves as a semipermeable membrane that, due to exposure to PD solutions, undergoes structural alterations, including peritoneal fibrosis, vasculopathy, and neoangiogenesis. In recent decades, oxidative stress (OS) has emerged as a novel risk factor for mortality and cardiovascular disease in PD patients. Moreover, it has become evident that OS plays a pivotal role in the pathogenesis and development of the chronic, progressive injury of the PM. In this review, we aimed to present several aspects of OS in PD patients, including the pathophysiologic effects on the PM, clinical implications, and possible therapeutic antioxidant strategies that might protect the integrity of PM during PD therapy.

The Need for Using An Enzymatic Colorimetric Assay in Creatinine Determination of Peritoneal Dialysis Solutions

1990 ◽  
Vol 10 (1) ◽  
pp. 89-92 ◽  
Author(s):  
Liliane Larpent ◽  
Christian Verger
Keyword(s):  
Peritoneal Dialysis ◽  
Reliable Method ◽  
Colorimetric Assay ◽  
Colorimetric Method ◽  
Peritoneal Membrane ◽  
Creatinine Kinetics ◽  
Dialysis Solutions ◽  
Peritoneal Dialysis Solutions ◽  
Enzymatic Test

The fate of the peritoneal membrane on continuous ambulatory peritoneal dialysis (CAPD) is usually evaluated through the modification of its permeability to various solutes as glucose, creatinine, and urea. Therefore, the accuracy of the methods used for measurements of creatinine is of great importance. A particular problem does exist for creatinine determination as it may be influenced by the presence of glucose. We studied a new enzymatic colorimetric method for creatinine determination in peritoneal dialysis solutions which contain high dextrose concentrations. Creatinine was measured in plasma, urine, and dialysate from 18 patients on CAPD and in pure dextrose solutions, with an enzymatic test (Boehringer Mannheim) and with Jaffe's reaction on two different analyzers: Astra (Beckman) and Eris (Merck). Creatinine results were similar with both assays (Jaffe's reaction and enzymatic test) when measured in blood and urine. However the Jaffe's reaction gave higher creatinine results than the enzymatic test (p < 0.001), when assays were performed in peritoneal dialysis solutions and in pure glucose solutions. In addition, it appeared that other components of dialysis solutions, mainly calcium chloride, influenced unpredictably the results of creatinine with the Jaffe's reaction. We conclude that specific enzymatic test is a more accurate and reliable method to evaluate creatinine kinetics through the peritoneal membrane when determined in CAPD solutions.

scholarly journals Effects of bicarbonate/lactate-buffered neutral peritoneal dialysis fluids on angiogenesis-related proteins in patients undergoing peritoneal dialysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hiromichi Ueno ◽  
Tetsu Miyamoto ◽  
Hiroyuki Morimoto ◽  
Kenya Sanada ◽  
Ikutaro Furuno ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Antibody Array ◽  
The Novel ◽  
Term Delivery ◽  
Cxc Chemokine ◽  
Related Proteins ◽  
Chemokine Family ◽  
Dialysis Fluids

Abstract Background In order to facilitate the safe and long-term delivery of peritoneal dialysis (PD), it is necessary to improve the biocompatibility of peritoneal dialysis fluids (PDFs). The novel bicarbonate/lactate-buffered neutral PDFs (B/L-PDFs) are expected to be improved biocompatible. This study evaluated the biocompatibility of B/L-PDFs by analysis on the profile of angiogenesis-related proteins in drained dialysate of patients undergoing PD. Methods Concentrations of 20 angiogenesis-related proteins in the dialysate were semi-quantitatively determined using a RayBio® Human Angiogenesis Antibody Array and were compared between B/L-PDFs and conventional lactate-buffered neutral PDFs (L-PDFs). Results The expression of growth-related oncogene (GRO α/β/γ), which belongs to the CXC chemokine family, decreased significantly after use of the B/L-PDFs compared to the L-PDFs (P = 0.03). The number of the proteins with lower level in the B/L-PDFs compared with L-PDFs was significantly negatively correlated with the PD duration (Spearman ρ = − 0.81, P = 0.004). Conclusion This study suggested that B/L-PDFs are more biocompatible than conventional PDFs.

Monitoring of Long-Term Peritoneal Membrane Function

2001 ◽  
Vol 21 (2) ◽  
pp. 225-232 ◽  
Author(s):  
Simon J. Davies
Keyword(s):  
Peritoneal Dialysis ◽  
Solute Transport ◽  
Water Transport ◽  
Drop Out ◽  
Published Data ◽  
Peritoneal Membrane ◽  
Membrane Function ◽  
Technique Survival ◽  
Ultrafiltration Failure

Objective Peritoneal membrane function influences dialysis prescription and clinical outcome and may change with time on treatment. Increasingly sophisticated tools, ranging from the peritoneal equilibration test (PET) to the standard permeability analysis (SPA) and personal dialysis capacity (PDC) test, are available to the clinician and clinical researcher. These tests allow assessment of a number of aspects of membrane function, including solute transport rates, ultrafiltration capacity, effective reabsorption, transcellular water transport, and permeability to macromolecules. In considering which tests are of greatest value in monitoring long-term membrane function, two criteria were set: those that result in clinically relevant interpatient differences in achieved ultrafiltration or solute clearances, and those that change with time in treatment. Study Selection Clinical validation studies of the PET, SPA, and PDC tests. Studies reporting membrane function using these methods in either long-term (5 years) peritoneal dialysis patients or longitudinal observations (> 2 years). Data Extraction Directly from published data. Additional, previously unpublished analysis of data from the Stoke PD Study. Results Solute transport is the most important parameter. In addition to predicting patient and technique survival at baseline, there is strong evidence that it can increase with time on treatment. Whereas patients with initially high solute transport drop out early from treatment, those with low transport remain longer on treatment, although, over 5 years, a proportion develop increasing transport rates. Ultrafiltration capacity, while being a composite measure of membrane function, is a useful guide for the clinician. Using the PET (2.27% glucose), a net ultrafiltration capacity of < 200 mL is associated with a 50% chance of achieving less than 1 L daily ultrafiltration at the expense of 1.8 hypertonic (3.86%) exchanges in anuric patients. Using a SPA (3.86% glucose), a net ultrafiltration capacity of < 400 mL indicates ultrafiltration failure. While there is circumstantial evidence that, with time on peritoneal dialysis, loss of transcellular water transport might contribute to ultrafiltration failure, none of the current tests is able to demonstrate this unequivocally. Of the other membrane parameters, evidence that interpatient differences are clinically relevant (permeability to macro-molecules), or that they change significantly with time on treatment (effective reabsorption), is lacking. Conclusion A strong case can be made for the regular assessment by clinicians of solute transport and ultrafiltration capacity, a task made simple to achieve using any of the three tools available.

Peritoneal Solute Clearances after four Years of Continuous Ambulatory Peritoneal Dialysis (CAPD)

1989 ◽  
Vol 9 (1) ◽  
pp. 75-78 ◽  
Author(s):  
Min Sun Park ◽  
Jean Lee ◽  
Moon Sung Lee ◽  
Seung Ho Baick ◽  
Seung Duk Hwang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Glucose Absorption ◽  
Peritoneal Membrane ◽  
Vasoactive Agents ◽  
Membrane Function ◽  
Dialysis Solution ◽  
Before And After ◽  
Dialysate Volume

In order to evaluate peritoneal membrane function and responsiveness of peritoneal microcirculation to vasoactive agents in long-term continuous ambulatory peritoneal dialysis (CAPD) patients, we studied peritoneal clearances of urea (Curea) and creatinine (Ccr), protein concentrations in drained dialysate (D PC), peritoneal glucose absorption (% GA), and drained dialysate volume ( VD) before and after nitroprusside (NP) addition to dialysis solution in 17 long-term CAPD patients (mean duration of CAPD: 52 months) and the results were compared to those of 18 patients who were just trained for CAPD (mean duration: 0.6 month). There were no differences in the control (without NP) Curea, Ccr, D PC, %GA, and VD between the new and long-term CAPD patients. Curea, Ccr, and D PC increased significantly with NP in both new and long-term patients. Curea and Ccr with NP were not different between the new and long-term patients but D PC with NP was significantly lower in the long-term CAPD patients. The results of this study suggest that peritoneal solute clearances and the responsiveness of peritoneal microcirculation to NP remain unchanged after four years of CAPD, despite recurrent episodes of peritonitis.

Glucose-Free Dialysis Solutions: Inductors of Inflammation or Preservers of Peritoneal Membrane?

2005 ◽  
Vol 25 (5) ◽  
pp. 453-460 ◽  
Author(s):  
Terhi A. Martikainen ◽  
Anna-Maija Teppo ◽  
Carola Grönhagen–Riska ◽  
Agneta V. Ekstrand
Keyword(s):  
Peritoneal Dialysis ◽  
Cell Mass ◽  
Mesothelial Cell ◽  
University Hospital ◽  
Intercellular Adhesion Molecule ◽  
Peritoneal Membrane ◽  
Cancer Antigen 125 ◽  
Necrosis Factor Alpha ◽  
Tnf Α ◽  
Dialysis Solutions

Objectives Glucose and other bioincompatible factors of conventional peritoneal dialysis solutions may damage the peritoneal membrane. The aim of our study was to investigate whether replacement of glucose with icodextrin (ID) or amino acids (AA) affects inflammatory parameters or cancer antigen 125 (CA125). Design Either ID or AA was used, in random order, in one daily exchange during an 8-week period. After the first study period, the patients entered a washout period and then switched to the other study solution for an 8-week period. C-reactive protein (CRP) was measured in serum, and CA125, tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), soluble intercellular adhesion molecule-1 (sICAM-1), and hyaluronan (HA) were measured in the overnight dwell dialysates at the beginning and end of the study periods. Setting A university hospital. Patients 22 patients with duration on peritoneal dialysis of 1.5 – 6.3 months. Main Outcome Measures Levels of serum CRP and dialysate CA125, IL-6, HA, and sICAM-1 during use of ID and AA were compared to levels during use of glucose-only-based solutions. Results CRP increased significantly during use of ID. CA125 increased significantly during 8 weeks’ use of AA, from 22.8 (5.4 – 89.0) to 42.9 (7.1 – 92.9) kU/L ( p = 0.007). IL-6 increased during 8 weeks’ use of AA, from 22.0 (9.0 – 108.0) to 36.5 (14.0 – 93.0) ng/L ( p = 0.002) and ID, from 25.5 (8.0 – 82.0) to 40.0 (12.0 – 118.0) ng/L ( p = 0.008). TNF-α also increased significantly during use of ID, but showed no significant changes during use of AA. Conclusions The use of glucose-free solutions, especially AA, may lead to preservation of mesothelial cell mass and host defense. However, activation of systemic and peritoneal inflammation may appear during the use of ID and to a lesser extent during use of AA.

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