Phosphatidylcholine and Chondroitin Sulphate in Peritoneal Dialysis Fluids to Preserve Membrane Function

Bręborowicz, Andrzej; Wieczorowska, K; Witowski, Janusz; Martis, Leo; Oreopoulos, Dimitrios G.

doi:10.1177/089686089401403s25

Cited by 12 publications

(4 citation statements)

References 41 publications

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“…We also found that this layer consists of glycosaminoglycans (including hyaluronan) and phospholipids at the peritoneal surface (65). It is thus not surprising that the surface layer may play an important role in modulating peritoneal transport, especially peritoneal fluid absorption, because several studies have demonstrated that phospholipids besides hyaluronan-especially phosphatidylcholine-could reduce the peritoneal fluid absorption rate and increase peritoneal fluid removal (66)(67)(68).…”

Section: Fluid Balance In Peritoneal Dialysismentioning

confidence: 99%

Peritoneal Dialysis Solutions

Wang

Lindholm

2001

Perit Dial Int

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Section: Fluid Balance In Peritoneal Dialysismentioning

confidence: 99%

Peritoneal Dialysis Solutions

Wang

Lindholm

2001

Perit Dial Int

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“…Apart from SAPL, effluent dialysate contains other substances with the potential to protect mesothelial surfaces, including various proteoglycans often found in other serous cavities, namely hyaluronic acid, heparan sulfate, dermatan sulfate, and chondroitin sulfate (58). It is tempting to speculate that such mucoid substances would act as a wetting agent to reduce the high interfacial energy that would otherwise occur between a hydrophobic tissue surface and aqueous fluid.…”

Section: Surfactant and Capdmentioning

confidence: 99%

Role of Surfactant in Peritoneal Dialysis

Hills

2000

Perit Dial Int

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Evidence is reviewed that demonstrates how the mesothelial cell in the normal peritoneum and comparable serosal cavities secretes surface-active phospholipid (SAPL) as a means of protecting itself and the membrane it forms with its neighbors. It is shown how SAPL, if adsorbed (reversibly bound) to mesothelium, can impart excellent lubricity, antiwear and release (antistick) properties, while impeding surgical adhesion formation. More-speculative benefits include acting as a deterrent to fibrosis and as a barrier to both protein leakage and pathogen invasion by spanning cell junctions. Such spanning would also “pin down” cell corners, impeding peeling as the first step in exfoliation encountered in prolonged continuous ambulatory peritoneal dialysis (CAPD). The molecular mechanism underlying each of these possible functions is adsorption. Morphological and hydrophobicity studies are discussed as validation for such an adsorbed lining and how it can be fortified by administering exogenous SAPL. Any role for SAPL in ultrafiltration is much more controversial. However, a surfactant lining can explain the very high permeability of the membrane to lipid-soluble drugs, implying that it is a barrier to water-soluble solutes. The clinical and animal evidence is conflicting but would seem to be best explained by a role for the barrier in promoting semipermeability, and hence the osmotic driving force for water transmission. Thus, adsorption of exogenous SAPL in CAPD patients with low ultrafiltration seems to restore this barrier function. The future direction for surfactant in CAPD would seem to rest with the physical chemists in producing formulations that optimize adsorption, probably involving a compromise between water solubility and surface activity of the phospholipids selected. It might even warrant using the interdialytic interval for re-adsorbing SAPL without the problem of dilution by a large volume of dialysate.

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“…Phosphatidylcholine has been claimed to improve UF in patients, but this result has not been confirmed. Furthermore, various effects on peritoneal fibrosis in rats have been reported (32).…”

Section: New Fluidsmentioning

confidence: 99%

Biocompatibility and New Fluids

Coles

1999

Perit Dial Int

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Phosphatidylcholine and Chondroitin Sulphate in Peritoneal Dialysis Fluids to Preserve Membrane Function

Cited by 12 publications

References 41 publications

Peritoneal Dialysis Solutions

Peritoneal Dialysis Solutions

Role of Surfactant in Peritoneal Dialysis

Biocompatibility and New Fluids

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