An Experimental Model for Study of Pharmacologic and Hormonal Influences on Peritoneal Dialysis

Jf, Maher; Hirszel, Przemyslaw; Lasrich, M

doi:10.1159/000402988

Cited by 37 publications

(6 citation statements)

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“…Similar results were found previously with intraperitoneal administration of this drug (7,20). The higher clearances with the use of verapamil may be due to an ultrafiltration increase (represented by drained dialysate), which is in agreement with other reports (21). Verapamil could affect ultrafiltration by modifying lymphatic flow.…”

Section: Discussionsupporting

confidence: 92%

Effect of Oral Administration of Losartan, Prazosin, and Verapamil on Peritoneal Solute Transport in Continuous Ambulatory Peritoneal Dialysis Patients

et al. 2005

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Background Several intraperitoneally administered drugs have been shown to modify transport of peritoneal solute and fluid. Fewer studies, however, have evaluated the effect of orally administered drugs. The present study was performed to evaluate the effects of oral losartan, prazosin, and verapamil on peritoneal membrane transport during a peritoneal equilibration test (PET), as well as the effects on creatinine clearance (CrCl), Kt/V urea, 24-hour protein in drained dialysate, and drained volume. Methods This was an open, controlled, crossover clinical trial performed in 20 patients on continuous ambulatory peritoneal dialysis. All subjects used four 2-L 1.5% glucose dialysis exchanges per day. After a 7-day washout period (without antihypertensives), they had a baseline standard PET and dialysis adequacy assessment performed. Subsequently, they were randomly allocated to receive the first of three study drugs (losartan, prazosin, and verapamil), which were administered orally for a 7-day period. Immediately after each drug period, patients had a new 3-day washout and subsequently started the next drug, until they had received each of the three drugs. On the last day of administration of each drug, patients were subjected to a new PET and adequacy of dialysis evaluation. Results None of the studied drugs significantly modified the peritoneal transport of creatinine, glucose, urea, sodium, potassium, or total protein as evaluated by PET. Verapamil significantly increased peritoneal CrCl [51.3 (44.3 – 53.3) vs baseline 45.8 (41.4 – 50.5) L/week/1.73 m2, p < 0.05], weekly Kt/V urea [1.75 (1.60 – 1.78) vs baseline 1.59 (1.54 – 1.73), p < 0.05], and drained dialysate volume [8.80 (8.30 – 8.96) vs baseline 8.44 (8.20 – 8.50) L/day, p < 0.05]. Conclusions Oral administration of losartan, prazosin, and verapamil did not modify the peritoneal transport of solutes during a 4-hour PET. Oral verapamil significantly increased CrCl, Kt/V urea, and 24-hour drained dialysate volume. It is most likely that verapamil increases peritoneal (hydraulic) conductivity, and then net ultrafiltration volume and convective transport of urea, creatinine, and protein. Verapamil could be considered as an alternative in patients requiring increased dialysis dose and/or ultrafiltration.

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Section: Discussionsupporting

confidence: 92%

Effect of Oral Administration of Losartan, Prazosin, and Verapamil on Peritoneal Solute Transport in Continuous Ambulatory Peritoneal Dialysis Patients

et al. 2005

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“…Peritoneal dialyses were conducted in alert, lightly restrained New Zealand white rabbits as outlined previously [2]. In brief, the supine animals averaging 4 kg in weight had 75 ml/kg of commer cially available dialysis solution instilled percutaneously through a 16-gauge needle over the course of 4 min.…”

Section: Methodsmentioning

confidence: 99%

“…These processes have different determinants [1], Moreover, they may oc cur through predominantly divergent channels. Al though the processes are passive, both pharmacological and physiological manipulations can influence the rates of diffusion and ultrafiltration [2], Recently we showed that intraperitoneal administration of commercially available amphotericin B significantly increased perito neal ultrafiltration rates, but affected solute transport only minimally [3].…”

mentioning

confidence: 99%

Contrasting Effects of Amphotericin B and the Solvent Sodium Desoxycholate on Peritoneal Transport

Maher¹,

Hirszel²,

Chakrabarti³

et al. 1986

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To distinguish amphotericin B effects on peritoneal transport from those of the solvent, sodium desoxycholate, dialyses in intact rabbits with either substance added intraperitoneally were compared to controls. Powdered amphotericin B added to instilled dialysis fluid increased peritoneal ultrafiltration from 0.31 to 0.44 ml/kg/ min (p < 0.02), but did not affect mass transport (e.g. urea clearance changed from 0.86 to 1.04 ml/kg/min). In contrast, 10 mg of desoxycholate induced peritoneal irritation and raised clearances of urea (0.76–1.34 ml/kg/min), potassium, phosphate and dextrose, but did not affect ultrafiltration. Intraperitoneally, 1 mg/kg of desoxycholate changed clearances inconsistently, but lowered the ultrafiltration rate from 0.33 to 0.21 ml/kg/min. The dialysate-plasma dextrose gradient dissipated faster with 10 mg/kg of desoxycholate. Amphotericin B tended to raise ultrafiltration per osmotic gradient and mass transport of sodium. Selective increase in fluid flux results from amphotericin B, not its solvent.

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“…Peritoneal dialysis was conducted in 10 New Zea land white rabbits, weighing 2.0-3.0 kg each, using a technique as previously described [5]. 100 mg of ke tamine was administered intramuscularly for sedation prior to the experiment.…”

Section: Methodsmentioning

confidence: 99%

Effect of Ultrafiltration on Peritoneal Dialysis Drug Clearances

et al. 1985

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To determine the effect of dialysate osmolarity on peritoneal dialysis drug transfer, peritoneal dialysis clearances of theophylline, phenobarbital, and tobramycin were determined in 10 rabbits using dialysate containing 1.5 and 4.25% glucose. Urea and creatinine clearances were also obtained for comparison. Under similar dialysis conditions, the peritoneal clearances of the three drugs remained unchanged for the two types of dialysate. In contrast, the peritoneal clearances of urea and creatinine were significantly higher with the use of 4.25 % glucose dialysate (p < 0.001). Thus, peritoneal dialysis clearances of theophylline, phenobarbital and tobramycin are not significantly affected by hypertonicity-induced ultrafiltration during acute peritioneal dialysis.

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An Experimental Model for Study of Pharmacologic and Hormonal Influences on Peritoneal Dialysis

Cited by 37 publications

References 0 publications

Effect of Oral Administration of Losartan, Prazosin, and Verapamil on Peritoneal Solute Transport in Continuous Ambulatory Peritoneal Dialysis Patients

Effect of Oral Administration of Losartan, Prazosin, and Verapamil on Peritoneal Solute Transport in Continuous Ambulatory Peritoneal Dialysis Patients

Contrasting Effects of Amphotericin B and the Solvent Sodium Desoxycholate on Peritoneal Transport

Effect of Ultrafiltration on Peritoneal Dialysis Drug Clearances

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