Advanced

Peritoneal Angiogenesis in Response to Dialysis Fluid.

Rippe, Bengt LU (2009) In Contributions to Nephrology 163(Jun 3). p.60-66
Abstract
In patients on peritoneal dialysis (PD) ultrafiltration failure (UFF) often develops after 3 or 4 years of treatment. Increased angiogenesis, leading to an increase in small solute transport, is a key feature of UFF. Among the pathophysiological mechanisms responsible for an increased angiogenesis, peritonitis, or just 'low-grade inflammation', such as in the uremic condition per se seem to be of importance. However, also the interaction of the peritoneal membrane with peritoneal dialysis fluids (PDF), especially those containing glucose and glucose degradation products (GDP) may be crucial in triggering an increased angiogenesis. This brief review summarizes some recent experimental evidence that PDF low in glucose and GDP, or with an... (More)
In patients on peritoneal dialysis (PD) ultrafiltration failure (UFF) often develops after 3 or 4 years of treatment. Increased angiogenesis, leading to an increase in small solute transport, is a key feature of UFF. Among the pathophysiological mechanisms responsible for an increased angiogenesis, peritonitis, or just 'low-grade inflammation', such as in the uremic condition per se seem to be of importance. However, also the interaction of the peritoneal membrane with peritoneal dialysis fluids (PDF), especially those containing glucose and glucose degradation products (GDP) may be crucial in triggering an increased angiogenesis. This brief review summarizes some recent experimental evidence that PDF low in glucose and GDP, or with an alternative buffer, pyruvate, may partly prevent angiogenesis in long-term PD. The fact that rat models of PD, in which catheters are used for instillation of the PDF, usually show an exaggerated neoangiogenesis, compared to rat models in which the PDF was administered by daily intraperitoneal injections, is also commented upon. To prevent angiogenesis in PD all precautions should be taken to provide a peritonitis-free PD. Although not directly proven, the use of low-GDP solutions should be preferred to GDP-containing solutions. Furthermore, ACE inhibitors have recently been shown to be of value in preventing increases in small solute transport in long-term PD. These findings await confirmation in randomized controlled trials. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Contributions to Nephrology
volume
163
issue
Jun 3
pages
60 - 66
publisher
Karger
external identifiers
  • WOS:000268507400009
  • PMID:19494596
  • Scopus:70349239202
ISSN
0302-5144
DOI
10.1159/000223781
language
English
LU publication?
yes
id
3f34b796-b230-4067-8135-f1b424715346 (old id 1434506)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19494596?dopt=Abstract
date added to LUP
2009-07-02 16:53:31
date last changed
2016-10-13 04:34:13
@misc{3f34b796-b230-4067-8135-f1b424715346,
  abstract     = {In patients on peritoneal dialysis (PD) ultrafiltration failure (UFF) often develops after 3 or 4 years of treatment. Increased angiogenesis, leading to an increase in small solute transport, is a key feature of UFF. Among the pathophysiological mechanisms responsible for an increased angiogenesis, peritonitis, or just 'low-grade inflammation', such as in the uremic condition per se seem to be of importance. However, also the interaction of the peritoneal membrane with peritoneal dialysis fluids (PDF), especially those containing glucose and glucose degradation products (GDP) may be crucial in triggering an increased angiogenesis. This brief review summarizes some recent experimental evidence that PDF low in glucose and GDP, or with an alternative buffer, pyruvate, may partly prevent angiogenesis in long-term PD. The fact that rat models of PD, in which catheters are used for instillation of the PDF, usually show an exaggerated neoangiogenesis, compared to rat models in which the PDF was administered by daily intraperitoneal injections, is also commented upon. To prevent angiogenesis in PD all precautions should be taken to provide a peritonitis-free PD. Although not directly proven, the use of low-GDP solutions should be preferred to GDP-containing solutions. Furthermore, ACE inhibitors have recently been shown to be of value in preventing increases in small solute transport in long-term PD. These findings await confirmation in randomized controlled trials.},
  author       = {Rippe, Bengt},
  issn         = {0302-5144},
  language     = {eng},
  number       = {Jun 3},
  pages        = {60--66},
  publisher    = {ARRAY(0x7b9e1a8)},
  series       = {Contributions to Nephrology},
  title        = {Peritoneal Angiogenesis in Response to Dialysis Fluid.},
  url          = {http://dx.doi.org/10.1159/000223781},
  volume       = {163},
  year         = {2009},
}