Effect of Pyrazinamide and Probenecid on Peritoneal Urate Transport Kinetics during Continuous Ambulatory Peritoneal Dialysis

Spaia, Sophia; Magoula, Ifigenia; Tsapas, George; Vayonas, George

doi:10.1177/089686080002000109

Cited by 16 publications

(6 citation statements)

References 27 publications

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“…Results of the present study do not show significant effects of losartan, prazosin, or verapamil on peritoneal transport of glucose, urea, creatinine, sodium, potassium, or total protein during a standard 4-hour PET. These results are in agreement with some previous studies (2,11,19) but contrast with others in which intraperitoneal drugs were used (1,4). No significant changes in D/P creatinine were found with oral enalapril (8), pyrazinamide, or probenecid (11) in the only two other studies reported in the literature.…”

Section: Discussionsupporting

confidence: 92%

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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%

“…In one study, oral enalapril significantly increased the dialysate-to-plasma ratio (D/P) of creatinine (8). In other works, enalapril and nifedipine increased the peritoneal clearance of creatinine and β2-microglobulin (10), and pyrazinamide and probenecid increased the peritoneal transport of urate (11).…”

mentioning

confidence: 91%

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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“…The exception to the rest of the solutes measured in this study was urate, which exhibited a shorter time constant than predicted for its molecular weight, possibly because it is an ion, although this usually results in longer time constants. This has not been reported previously, although there are data that suggest that unrestricted diffusion is not the only mechanism of urate transport across the peritoneal membrane [13].…”

Section: Total Body Watermentioning

confidence: 66%

Measuring transport of water across the peritoneal membrane

Asghar¹,

Diskin²,

Španěl³

et al. 2003

Kidney International

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“…There might be a slight interaction of urate with albumin, but literature data are ambiguous on this point. The apparently modulating effect on urate transport observed with certain drugs, such as pyrazinamide and probenecid, is intriguing and requires further investigation, especially whether there could be some interactions of these drugs with the association of urate with plasma proteins (albumin) (89).…”

Section: Lactate and Uratementioning

confidence: 99%

Fluid and Electrolyte Transport across the Peritoneal Membrane during CAPD According to the Three-pore Model

et al. 2004

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In the present review, we summarize the principles governing the transport of fluid and electrolytes across the peritoneum during continuous ambulatory peritoneal dialysis (CAPD) in “average” patients and during ultrafiltration failure (UFF), according to the three-pore model of peritoneal transport. The UF volume curves as a function of dwell time [V( t)] are determined in their early phase by the glucose osmotic conductance [product of the UF coefficient (LpS) and the glucose reflection coefficient (σg)] of the peritoneum; in their middle portion by intraperitoneal volume and glucose diffusivity; and in their late portion by the LpS, Starling forces, and lymph flow. The most common cause of UFF is increased transport of small solutes (glucose) across the peritoneum, whereas the LpS is only moderately affected. Concerning peritoneal ion transport, ions that are already more or less fully equilibrated across the membrane at the start of the dwell, such as Na+ (Cl–), Ca2+, and Mg2+, have a convection-dominated transport. The removal of these ions is proportional to UF volume (approximately 10 mmol/L Na+ and 0.12 mmol/L Ca2+ removed per deciliter UF in 4 hours). The present article examines the impact on fluid and solute transport of varying concentrations of Ca2+ and Na+ in peritoneal dialysis solutions. Particularly, the effect of “ultralow” sodium solutions on transport and UF is simulated and discussed. Ions with high initial concentration gradients across the peritoneum, such as K+, phosphate, and bicarbonate, display a diffusion-dominated transport. The transport of these ions can be adequately described by non-electrolyte equations. However, for ions that are in (or near) their diffusion equilibrium over the peritoneum (Na+, Ca2+, Mg2+), more complex ion transport equations need to be used. Due to the complexity of these equations, however, non-electrolyte transport formalism is commonly employed, which leads to a marked underestimation of mass transfer area coefficients (PS). This can be avoided by determining the PS when transperitoneal ion concentration gradients are steep.

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Effect of Pyrazinamide and Probenecid on Peritoneal Urate Transport Kinetics during Continuous Ambulatory Peritoneal Dialysis

Cited by 16 publications

References 27 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

Measuring transport of water across the peritoneal membrane

Fluid and Electrolyte Transport across the Peritoneal Membrane during CAPD According to the Three-pore Model

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