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Biocompatibility of peritoneal dialysis fluids: long-term exposure of nonuremic rats.

Artikel i vetenskaplig tidskrift
Författare Barbara Musi
Magnus Braide
Ola Carlsson
Anders Wieslander
Ann Albrektsson
Markus Ketteler
Ralf Westenfeld
Jürgen Floege
Bengt Rippe
Publicerad i Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis
Volym 24
Nummer/häfte 1
Sidor 37-47
ISSN 0896-8608
Publiceringsår 2004
Publicerad vid Institutionen för de kirurgiska disciplinerna, Avdelningen för biomaterialvetenskap
Institutionen för anatomi och cellbiologi
Sidor 37-47
Språk en
Länkar www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Animals, Buffers, Glucose, metabolism, pharmacology, Hemodialysis Solutions, pharmacology, Lactates, pharmacology, Male, Peritoneal Dialysis, Peritoneum, drug effects, pathology, Rats, Rats, Sprague-Dawley, Time Factors
Ämneskategorier Medicin och Hälsovetenskap

Sammanfattning

OBJECTIVES: Long-term peritoneal dialysis (PD) leads to structural and functional changes in the peritoneum. The aim of the present study was to investigate the long-term effects of PD fluid components, glucose and glucose degradation products (GDP), and lactate-buffered solution on morphology and transport characteristics in a nonuremic rat model. METHODS: Rats were subjected to two daily intraperitoneal injections (20 mL/day) during 12 weeks of one of the following: commercial PD fluid (Gambrosol, 4%; Gambro AB, Lund, Sweden), commercial PD fluid with low GDP levels (Gambrosol trio, 4%; Gambro AB), sterile-filtered PD fluid (4%) without GDP, or a glucose-free lactate-buffered PD fluid. Punctured and untreated controls were used. Following exposure, the rats underwent a single 4-hour PD dwell (30 mL, 4% glucose) to determine peritoneal function. Additionally, submesothelial tissue thickness, percentage of high mesothelial cells (perpendicular diameter > 2 microm), vascular density, vascular endothelial growth factor (VEGF), and transforming growth factor (TGF) beta1 mRNA expression were determined. Submesothelial collagen concentration was estimated by van Gieson staining. RESULTS: Submesothelial tissue thickness and vascular density, mediated by VEGF and TGFbeta production, in the diaphragmatic peritoneum increased significantly in rats exposed to any PD fluid. Gambrosol induced a marked increased fibrosis of the hepatic peritoneum. A significant increase in high mesothelial cells was observed in the Gambrosol group only. Net ultrafiltration was reduced in the Gambrosol and in the glucose-free groups compared to untreated controls. Small solute transport was unchanged, but all groups exposed to fluids showed significantly increased lymph flow. CONCLUSIONS: Our results show that long-term exposure to different components of PD fluids leads to mesothelial cell damage, submesothelial fibrosis, and neoangiogenesis. Mesothelial cell damage could be connected to the presence of GDP; the other changes were similar for all fluids. Peritoneal transport characteristics did not change in any consistent way and the neoangiogenesis observed was not paralleled by increased solute transport.

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