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Neuropeptide Release Augments Serum Albumin Loss and Reduces Ultrafiltration in Peritoneal Dialysis

Artikel i vetenskaplig tidskrift
Författare Nicola Cavallini
Dick Delbro
Gunnar Tobin
Magnus Braide
Publicerad i Peritoneal dialysis international
Volym 32
Nummer/häfte 2
Sidor 168-176
ISSN 0896-8608
Publiceringsår 2012
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för farmakologi
Institutionen för biomedicin, avdelningen för medicinsk kemi och cellbiologi
Sidor 168-176
Språk en
Länkar dx.doi.org/10.3747/pdi.2010.00254
Ämnesord Inflammation, peritoneal membrane, ultrafiltration
Ämneskategorier Klinisk medicin

Sammanfattning

BACKGROUND: The triggers of the acute local inflammatory response to peritoneal dialysis (PD) fluid exposure remain unknown. In the present study, we investigated the effects of neurogenic inflammation and mast cell degranulation on water and solute transport in experimental PD. METHODS: Single 2-hour dwells in rats with PD catheters were studied. Histamine and the neuropeptides substance P and calcitonin gene-related peptide (CGRP) were measured in PD fluid samples by ELISA. Radiolabeled albumin (125I and 131I respectively) was used as an intraperitoneal (IP) and intravascular tracer. Glucose and urea concentrations were measured in plasma and PD fluid. The effects of varying the volume and osmolarity of a lactate-buffered PD fluid were compared and related to the effects of pharmacologicintervention. RESULTS: Application of 20 mL 3.9% glucose PD fluid induced an IP histamine release during the first 30 minutes, blockable by the mast cell stabilizer doxantrazole and the substance P neurokinin-1 receptor (NK1R)-blocker spantide. Histamine release was also inhibited at a reduced PD volume (14 mL), but was not affected by normalizing the PD fluid osmolarity. Blockade of NK1R also reduced plasma albumin leakage to the peritoneal cavity. Inhibition of CGRP receptors by CGRP8-37 improved osmotic (transcapillary) and net ultrafiltration and reduced the dialysate urea concentration. Neuropeptide release was not clearly related to activation of the TrpV1 receptor, the classic trigger of neurogenic inflammation. CONCLUSIONS: Neuropeptide release exaggerated albumin loss and reduced ultrafiltration in this rat PD model. Intervention aimed at the neuropeptide action substantially improved PD efficiency.

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