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Does Enalapril Prevent Peritoneal Fibrosis Induced by Hypertonic (3.86%) Peritoneal Dialysis Solution?
- Source :
- Europe PubMed Central
- Publication Year :
- 2001
- Publisher :
- SAGE Publications, 2001.
-
Abstract
- Objective Peritoneal fibrosis (PF) is one of the most serious causes of failure in continuous ambulatory peritoneal dialysis (PD). Although the underlying mechanism responsible for the genesis of PF is still unknown, transforming growth factor p (TGFβ1) has been shown to be associated with PF. Angiotensin converting enzyme inhibitors have been shown to prevent the stimulating effect of growth factors. The aim of the present study was to investigate the effect of enalapril on peritoneal function and morphology in a rat model of experimental PF. Methods Twenty-one albino Wistar rats were divided into three groups: ( 1 ) the control group (C) received 10 mL isotonic saline intraperitoneally (IP), ( 2 ) the dextrose (Dx) group 10 mL 3.86% dextrose PD solution IP, and ( 3 ) the enalapril-treated group (ENA) 10 cc 3.86% dextrose PD solution IP plus 100 mg/L enalapril in drinking water. After 4 weeks, a 1-hour peritoneal equilibration test was performed with 20 mL 2.27% dextrose PD solution. Dialysate-to-plasma urea ratio (D/P urea), glucose reabsorption (D1/D0 glucose), ultrafiltration (UF) volume, and levels of dialysate protein, TGFβ1, and cancer antigen 125 (CA125) were determined. The parietal peritoneum was evaluated histologically by light microscopy. Results Administration of enalapril resulted in preserved UF (-0.2 ± 0.7 mL vs 1.7 ± 0.3 mL, p < 0.05), protein loss (2.3 ± 0.5 g/L vs 1.6 ± 0.2 g/L, p > 0.05), and peritoneal thickness (77 ± 7 μ vs 38 ± 5 μ, p < 0.001). D/P urea increased significantly in the Dx group ( p < 0.05). Both higher levels of TGFβ1 (undetectable vs 298 ± 43 pg/mL, p < 0.001) and lower levels of CA125 in dialysate effluent (0.94 ± 0.5 U/L vs 0.11 ± 0.1 U/L, p > 0.05) were determined in the Dx group. Conclusion These findings show that peritoneal morphology and function tests were dramatically deranged in the Dx group. The same properties were partially preserved in the ENA group. The production of TGFβ1 was significantly reduced but peritoneal thickness was not completely inhibited. In conclusion, by inhibiting the production of TGFβ1, enalapril can preserve peritoneal histology, peritoneal function, and remodeling of mesothelial cells.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Hypertonic Solutions
030232 urology & nephrology
Urology
Angiotensin-Converting Enzyme Inhibitors
030204 cardiovascular system & hematology
Peritoneal dialysis
03 medical and health sciences
0302 clinical medicine
Enalapril
Peritoneal Dialysis, Continuous Ambulatory
Transforming Growth Factor beta
Fibrosis
Dialysis Solutions
medicine
Animals
Urea
Rats, Wistar
Peritoneal Fibrosis
business.industry
Continuous ambulatory peritoneal dialysis
Proteins
General Medicine
medicine.disease
Rats
Glucose
Nephrology
Proteins metabolism
Tonicity
Peritoneum
business
Urea metabolism
medicine.drug
Subjects
Details
- ISSN :
- 17184304 and 08968608
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
- Accession number :
- edsair.doi.dedup.....709098c612176436b56fd7db8e49c037