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

Maher, John F.; Hirszel, Przemyslaw; Chakrabarti, Eva; Bennett, Robin R.

doi:10.1159/000183715

Cited by 17 publications

(6 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The factors responsible are the local cytokine production and dextrose in the dialysate. [17–19] During this waiting period, the patient who is initiated on dialysis is given an empirical dialysis prescription due to non-assessment of the membrane character.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of peritoneal transport characteristics at the second week and at six months of peritoneal dialysis commencement

et al. 2013

View full text Add to dashboard Cite

Peritoneal equilibration test (PET) is an important tool for managing peritoneal dialysis (PD) prescription. The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines suggest that the first PET be performed 4-8 weeks after PD commencement. The main reason for this delay is because of the peritoneal membrane might change its character once it is exposed to the glucose based dialysate. In this study, we compared PET 2 weeks after PD commencement to PET after 6 months to evaluate the changes in the peritoneal membrane character with time. This study included 126 patients who underwent PD initiation between March 2007 and December 2011. The PET was performed as per the standard protocol at 2nd week and 6th month after PD initiation. Transport status was categorized as low, low average, high average, and high as per the standard definition. There was no change in transport character in 115 patients (91.2%) between the two PET measurements. When the Early PET at 2nd week and 6th month PET data were analyzed, no significant changes were observed in measured D/P creatinine (0.59 ± 0.14 vs. 0.62 ± 0.14 respectively P = 0.26) and D/D0 Glucose (0.46 ± 0.12 vs. 0.46 ± 0.11, P = 0.65). Using the Bland-Altman analysis the repeatability coefficients were 0.27 and 0.25 for creatinine and glucose values respectively. In our study, the PET performed at the 2nd week are similar to that of the 6th month PET in 91.2% of our patients and the test did not significantly change with time. In conclusion, we could do PET early at 2nd week to assess the peritoneal membrane character and this would help in proper dialysis prescription to the patients.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The reasons believed to be responsible for the change in the membrane character in the early stages are due to the dialysate induced changes in the local inflammatory cytokine production, dextrose induced changes in the peritoneal blood flow, and peritoneal vascularity. [17–19]…”

Section: Introductionmentioning

confidence: 99%

Comparison of peritoneal transport characteristics at the second week and at six months of peritoneal dialysis commencement

et al. 2013

View full text Add to dashboard Cite

show abstract

“…KEY WORDS: Longitudinal peritoneal dialysis model; peritoneal transport; rabbits. M ost models of peritoneal dialysis (PD) in rabbits have focused on interventions in peritoneal transport through experiments during short-term PD in anesthetized animals (1)(2)(3)(4). In the limited number of longitudinal rabbit models, emphasis has been mainly on clinical parameters and histopathological changes (5)(6)(7)(8)(9).…”

Section: ♦ ♦ ♦ ♦ ♦ Conclusionmentioning

confidence: 99%

The Standard Peritoneal Permeability Analysis in the Rabbit: A Longitudinal Model for Peritoneal Dialysis

Zweers

Douma

Waart³

et al. 1999

Perit Dial Int

View full text Add to dashboard Cite

Objective The development of an experimental peritoneal dialysis (PD) model in rabbits to investigate peritoneal transport characteristics during a longitudinal follow-up and to assess normal values of these peritoneal transport parameters. Design Peritoneal transport parameters were determined in conscious, unrestrained rabbits by standard peritoneal permeability analysis adjusted for rabbits (SPAR). In this test a 1-hour dwell with 3.86% glucose dialysate is used. Dextran 70 (1 g/L) was added to the dialysate to allow calculation of fluid kinetics. Dialysate samples were taken before, 10, and 40 minutes after instillation and at the end of the dwell. Blood was drawn at the end of the dwell. Experimental Animals Eighteen female New Zealand White rabbits (2565 g) were included for catheter implantation. SPARs were performed in 15 animals; the other 3 were excluded due to complications. Main Outcome The mass transfer area coefficients (MTACs) of the low molecular weight solutes urea (MTACurea) and creatinine (MTACcr) were calculated. The clearances of albumin (Clalb) and IgG (ClIgG), glucose absorption, and fluid transport were computed. Coefficients of intraindividual variation (Vc) were calculated for these parameters. Results The main complications were catheter obstruction and/or dislocation. Five rabbits underwent uncomplicated PD during a 4-week period. Fifteen SPARs in 15 stable rabbits were performed and analyzed to obtain normal values. Means and standard deviations of the transport parameters were as follows: MTACurea 2.24 ± 0.57 mL/min, MTACcr 1.61 ± 0.30 mL/min, Clalb 52.9 ± 17.2 μL/min, ClIgG 44.5 ± 22.9 μL/min. The transcapillary ultrafiltration rate was 0.66 ± 0.13 mL/min and the lymphatic absorption rate 0.47 ± 0.26 mL/min. The parameters of solute transport were upscaled to those in humans using two different methods. MTACs of low molecular weight solutes in rabbits and patients were of the same order of magnitude, but the clearance of albumin was approximately four times higher in rabbits than in patients, and that of IgG eight times. In all rabbits sieving of sodium was observed. The dialysate/plasma (D/P) of sodium decreased to a minimum at 40 min ( p < 0.003 vs the initial value), followed by a rise to 60 min. The minimal value was 0.884 ± 0.002. The coefficients of variation calculated on 7 rabbits that underwent two or more SPARs were similar to those assessed from the patient data. This indicates stability of the model and reproducibility of the SPAR. Conclusion The conscious rabbit model for PD can be used for repeated studies on peritoneal transport.

show abstract

“…P reservation of ultrafiltration (UF) volume is a major concern in maintaining long-term continuous ambulatory peritoneal dialysis (CAPD), since loss of UF volume is the main reason for patient dropout. Several pharmacological agents have proven to be effective in enhancing solute transport and water transport (1)(2)(3)(4)(5)(6)(7)(8)(9). However, they have not been used in clinical practice because their clinical usefulness has not yet been established.…”

Section: ♦ ♦ ♦ ♦ ♦ Conclusionmentioning

confidence: 99%

Tranexamic Acid Increases Peritoneal Ultrafiltration Volume in Patients on Capd

et al. 1999

View full text Add to dashboard Cite

Objective The preservation of ultrafiltration (UF) capacity is crucial to maintaining long-term continuous ambulatory peritoneal dialysis (CAPD). The aim of the present study was to investigate whether the antiplasmin agent tranexamic acid (TNA) increases UF volume in CAPD patients. Patients and Methods Fifteen patients on CAPD, 5 with UF loss and 10 without UF loss, were recruited for the study. The effect of TNA was evaluated with respect to changes in UF volume, peritoneal permeability, peritoneal clearance, bradykinin (BK), and tissue plasminogen activator (tPA) concentration. Setting Dialysis unit of the Saiseikai Central Hospital. Results In patients with UF loss, 2 weeks of treatment with oral TNA produced a significant increase in UF volume in all subjects (5/5). TNA also produced a significant increase in peritoneal clearances of urea and creatinine (Cr). However, the peritoneal equilibration test (PET) revealed that TNA had no effect on dialysate/plasma (D/P) Cr, Kt/V, or the protein catabolic rate (PCR). TNA also had no effect on net glucose reabsorption. In contrast, significant decreases in BK and blood tPA concentrations in response to TNA treatment were noted. BK concentration in drainage fluid was also reduced. In the case of patients without UF loss, TNA produced an increase in UF volume in 70% (7/10). However, no differences were found in blood and drainage BK and tPA concentrations between the TNA treatment and nontreatment periods in these patients. A comparison of basal BK and tPA concentration showed that there were no differences in these parameters between patients with UF loss and those without loss of UF. Furthermore, TNA given intraperitoneally to a patient also produced a marked increase in UF volume. Conclusion The present study suggests that TNA enhances UF volume in patients both with and without UF loss. Since TNA did not affect peritoneal permeability and glucose reabsorption, the mechanism by which TNA exerts an enhancing action on UF is largely unknown. We speculate that it may be associated with suppression of the BK and/or tPA system, at least in patients with UF loss.

show abstract

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

Cited by 17 publications

References 8 publications

Comparison of peritoneal transport characteristics at the second week and at six months of peritoneal dialysis commencement

Comparison of peritoneal transport characteristics at the second week and at six months of peritoneal dialysis commencement

The Standard Peritoneal Permeability Analysis in the Rabbit: A Longitudinal Model for Peritoneal Dialysis

Tranexamic Acid Increases Peritoneal Ultrafiltration Volume in Patients on Capd

Contact Info

Product

Resources

About