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首页> 外文期刊>Peritoneal dialysis international: Journal of the International Society for Peritoneal Dialysis >Intraperitoneal addition of hyaluronan improves peritoneal dialysis efficiency.
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Intraperitoneal addition of hyaluronan improves peritoneal dialysis efficiency.

机译：腹膜内添加透明质酸可提高腹膜透析效率。

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摘要

BACKGROUND: It has been shown that hyaluronan (HA) can decrease peritoneal fluid absorption. It is not known, however, how various molecular weights and various concentrations of hyaluronan affect peritoneal fluid absorption rate. METHODS: A study of 4-hour dwells, with frequent dialysate and blood sampling, was performed in male Sprague-Dawley rats (6-7 rats in each group) with 131I albumin as an intraperitoneal volume marker. Each rat was infused intraperitoneally with 25 mL of 1.5% glucose solution alone or 1.5% glucose solution containing hyaluronan at various molecular weights (MW-85 kD, 280 kD, 500 kD, and 4 MD) or containing hyaluronan of MW 500 kD at various concentrations (0.01%, 0.05%, 0.1%, 0.5%). Two additional groups were infused with 40 mL of 1.36% glucose dialysate alone or 1.36% glucose dialysate with 0.01% hyaluronan (MW 500 kD) to test the effect of hyaluronan when high dialysate fill volume was used. RESULTS: Addition of 0.01% hyaluronan significantly decreased peritoneal fluid absorption rate (K(E)) (by 22%, p < 0.01). The decrease was more marked with hyaluronan at high MW or high concentration, or with high dialysate fill volume. The net ultrafiltration tended to be higher in all hyaluronan groups compared to their control groups except in the 4 MD group; this difference was mainly due to a lower K(E) in all the hyaluronan groups. The direct lymphatic flow was significantly decreased in the 0.5% HA group. The transcapillary ultrafiltration rate (Qu) was significantly lower in the 4 MD group as compared to the control group. No difference in Qu was found between the other groups as compared to their control groups. CONCLUSIONS: (1) Intraperitoneal addition of hyaluronan may increase net peritoneal fluid removal, mainly because hyaluronan decreases peritoneal fluid absorption rate. The decrease was more marked when high dialysate fill volume was used, indicating that intraperitoneal addition of hyaluronan can prevent the decreased net ultrafiltration caused by an increase in dialysate fill volume. (2) The decrease in peritoneal fluid absorption rate may be both MW-dependent and concentration-dependent: that is, a higher MW as well as a higher concentration of hyaluronan result in a more marked decrease in peritoneal fluid absorption rate. (3) Low concentrations of high MW hyaluronan may also decrease Qu. However, Qu did not decrease when high concentrations of hyaluronan were used despite a significant decrease in peritoneal fluid absorption rate.
机译：背景：已显示透明质酸（HA）可降低腹膜液吸收。但是，不清楚各种分子量和各种浓度的透明质酸如何影响腹膜液吸收速率。方法：对雄性Sprague-Dawley大鼠（每组6-7只大鼠）以131I白蛋白作为腹膜内体积标记物进行了4小时的研究，并进行了频繁的透析液和血液采样。每只大鼠腹膜内注射25 mL的1.5％葡萄糖溶液或1.5％的葡萄糖溶液，其中含有不同分子量（MW-85 kD，280 kD，500 kD和4 MD）的透明质酸或含有MW 500 kD的透明质酸。浓度（0.01％，0.05％，0.1％，0.5％）。另外两组分别输注40 mL的1.36％葡萄糖透析液或1.36％葡萄糖透析液和0.01％透明质酸（MW 500 kD），以测试使用高透析液填充量时透明质酸的效果。结果：添加0.01％的透明质酸可显着降低腹膜液吸收率（K（E））（降低22％，p <0.01）。在高分子量或高浓度的透明质酸或高透析液填充量的情况下，这种下降更为明显。除4 MD组外，所有透明质酸组的净超滤趋势均高于对照组。这种差异主要是由于所有透明质酸组的K（E）较低。 0.5％HA组的直接淋巴流量明显减少。与对照组相比，4 MD组的毛细血管超滤率（Qu）显着降低。与其他对照组相比，其他组之间的Qu差异无统计学意义。结论：（1）腹膜内添加透明质酸可增加腹膜净液的去除，这主要是因为透明质酸降低了腹膜液的吸收率。当使用高的透析液填充量时，下降更明显，表明腹膜内添加透明质酸可以防止由于透析液填充量增加而引起的净超滤减少。 （2）腹膜液吸收率的降低可能与MW有关，也与浓度有关：也就是说，更高的MW和更高的乙酰透明质酸浓度会导致腹膜液吸收率的下降更为明显。 （3）低浓度的高分子量透明质酸也可能降低Qu。然而，尽管腹膜液吸收率明显降低，但使用高浓度的透明质酸时Qu并没有降低。

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