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Mortier S, Lameire NH, De Vriese AS. Animal Models in Peritoneal Dialysis Research: A Need for Consensus. Perit Dial Int 2020. [DOI: 10.1177/089686080502500105] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The development of an adequate animal model for peritoneal research remains an object of concern. In vivo peritoneal dialysis (PD) research is hampered by the large variety of available models that make interpretation of results and comparison of studies very difficult. Species and strain of experimental animals, method of peritoneal access, study duration, measures of solute transport and ultrafiltration, and sampling for histology differ substantially among the various research groups. A collective effort to discuss the shortcomings and merits of the different experimental models may lead to a consensus on a standardized animal model of PD.
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De Vriese AS, Mortier S, Cornelissen M, Palmans E, Vanacker NJ, Leyssens A, Faict D, De Ridder L, Lameire NH. The Effects of Heparin Administration in an Animal Model of Chronic Peritoneal Dialysate Exposure. Perit Dial Int 2020. [DOI: 10.1177/089686080202200507] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Diverse modes of heparin administration have been used in animal models of chronic peritoneal dialysate exposure to maintain catheter patency and prevent fibrinous adhesions. Heparin has biological actions independent of its well-known anticoagulant activity, including the ability to modulate extracellular matrix synthesis, cellular proliferation, angiogenesis, and inflammation. These actions may interfere with peritoneal membrane homeostasis. The present study evaluated the influence of the mode of heparin administration on technique survival and infection rate in a rat model of chronic dialysate exposure. Further, the incorporation of heparin in the peritoneal membrane was examined. A 3.86% glucose dialysate was injected twice daily into Wistar rats with a heparin-coated catheter (group A1), or with a standard catheter with heparin injections during the entire exposure time (group A2) or only during 1 week (group A3). Sham manipulations were performed in a fourth group and a fifth group was left untreated. Technique survival was 80% in group A1, 60% in group A2, and 40% in group A3. The rate of infection was highest in group A1 and lowest in group A2. Intraperitoneally administered heparin accumulated in the peritoneal membrane, whereas dextran, with a molecular weight similar to that of heparin, was not incorporated in the peritoneum. In conclusion, intraperitoneal heparin reduced the incidence of infection in an animal model of chronic dialysate exposure. The best technique survival was, however, obtained using a heparin-coated catheter. Heparin is incorporated in the peritoneal membrane, where it may exert diverse biological actions and thus bias study results. The use of a heparin-coated catheter in combination with antibiotics may be the optimal approach to obtaining peritoneal access in animal models of chronic dialysate exposure.
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Affiliation(s)
- An S. De Vriese
- Renal Unit; Department of Anatomy, Embryology, Histology, Section Histology Nivelles, Belgium
| | - Siska Mortier
- Renal Unit; Department of Anatomy, Embryology, Histology, Section Histology Nivelles, Belgium
| | - Maria Cornelissen
- Renal Unit; Department of Anatomy, Embryology, Histology, Section Histology Nivelles, Belgium
| | - Els Palmans
- Department of Respiratory Diseases, Nivelles, Belgium
| | | | - Anne Leyssens
- University Hospital, Ghent; Baxter R&D Europe, Nivelles, Belgium
| | - Dirk Faict
- University Hospital, Ghent; Baxter R&D Europe, Nivelles, Belgium
| | - Leo De Ridder
- Renal Unit; Department of Anatomy, Embryology, Histology, Section Histology Nivelles, Belgium
| | - Norbert H. Lameire
- Renal Unit; Department of Anatomy, Embryology, Histology, Section Histology Nivelles, Belgium
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Abstract
Peritoneal dialysis (PD) is a successfully used method for renal replacement therapy. However, long-term PD may be associated with peritoneal fibrosis and ultrafiltration failure. The key factors linked to their appearance are repeated episodes of inflammation associated with peritonitis and long-term exposure to bioincompatible PD fluids. Different strategies have been proposed to preserve the peritoneal membrane. This article reviews the functional and structural alterations related to PD and strategies whereby we may prevent them to preserve the peritoneal membrane. The use of new, more biocompatible, PD solutions is promising, although further morphologic studies in patients using these solutions are needed. Blockade of the renin-angiotensin-aldosterone system appears to be efficacious and strongly should be considered. Other agents have been proven in experimental studies, but most of them have not yet been tested appropriately in human beings.
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Affiliation(s)
- M Auxiliadora Bajo
- Home Dialysis Unit, Nephrology Department, La Paz University Hospital, Madrid, Spain.
| | - Gloria Del Peso
- University Autónoma of Madrid, Hospital La Paz Institute for Health Research, Spanish Renal Research Network, Reina Sofia Institute for Nephrology Research, Madrid, Spain
| | - Isaac Teitelbaum
- Home Dialysis Program, University of Colorado Hospital, University of Colorado School of Medicine, Aurora, CO
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Makarchian HR, Kasraianfard A, Ghaderzadeh P, Javadi SMR, Ghorbanpoor M. The effectiveness of heparin, platelet-rich plasma (PRP), and silver nanoparticles on prevention of postoperative peritoneal adhesion formation in rats. Acta Cir Bras 2017; 32:22-27. [PMID: 28225914 DOI: 10.1590/s0102-865020170103] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 12/19/2016] [Indexed: 12/11/2022] Open
Abstract
Purpose: To assess the effectiveness of heparin, platelet-rich plasma (PRP), and silver nanoparticles on prevention of postoperative adhesion in animal models. Methods: Sixty males Albino Wistar rats aged 5 to 6 weeks were classified into five groups receiving none, heparin, PRP, silver nanoparticles, PRP plus silver nanoparticles intraperitoneally. After 2 weeks, the animals underwent laparotomy and the damaged site was assessed for peritoneal adhesions severity. Results: The mean severity scores were 2.5 ± 0.9, 2.16 ± 0.7, 1.5 ± 0.5, 2.66 ± 0.88, and 2.25 ± 0.62 in the control, heparin, PRP, silver and PRP plus silver groups, respectively with significant intergroup difference (p = 0.004). The highest effective material for preventing adhesion formation was PRP followed by heparin and PRP plus silver. Moreover, compared to the controls, only use of PRP was significantly effective, in terms of adhesion severity (p = 0.01) . Conclusion: Platelet-rich plasma alone may have the highest efficacy for preventing postoperative peritoneal adhesions in comparison with heparin, silver nanoparticles and PRP plus silver nanoparticles.
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Affiliation(s)
- Hamid Reza Makarchian
- Assistant Professor, Department of Surgery, Hamadan University of Medical Sciences, Hamadan, Iran. Scientific, intellectual, conception and design of the study; critical revision
| | - Amir Kasraianfard
- MD, Resident, Department of Surgery, Hamadan University of Medical Sciences, Hamadan, Iran. Statistics analysis, manuscript writing
| | - Pezhman Ghaderzadeh
- MD, Department of Surgery, Hamadan University of Medical Sciences, Hamadan, Iran. Acquisition of data, manuscript preparation
| | - Seyed Mohammad Reza Javadi
- Assistant Professor, Department of Surgery, Hamadan University of Medical Sciences, Hamadan, Iran. Analysis and interpretation of data, critical revision
| | - Manoochehr Ghorbanpoor
- Assistant Professor, Department of Surgery, Hamadan University of Medical Sciences, Hamadan, Iran. Critical revision, final approval of the manuscript
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Nikitidou O, Peppa VI, Leivaditis K, Eleftheriadis T, Zarogiannis SG, Liakopoulos V. Animal models in peritoneal dialysis. Front Physiol 2015; 6:244. [PMID: 26388781 PMCID: PMC4555018 DOI: 10.3389/fphys.2015.00244] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 08/17/2015] [Indexed: 12/20/2022] Open
Abstract
Peritoneal dialysis (PD) has been extensively used over the past years as a method of kidney replacement therapy for patients with end stage renal disease (ESRD). In an attempt to better understand the properties of the peritoneal membrane and the mechanisms involved in major complications associated with PD, such as inflammation, peritonitis and peritoneal injury, both in vivo and ex vivo animal models have been used. The aim of the present review is to briefly describe the animal models that have been used, and comment on the main problems encountered while working with these models. Moreover, the differences characterizing these animal models, as well as, the differences with humans are highlighted. Finally, it is suggested that the use of standardized protocols is a necessity in order to take full advantage of animal models, extrapolate their results in humans, overcome the problems related to PD and help promote its use.
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Affiliation(s)
- Olga Nikitidou
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, School of Medicine, American Hellenic Educational Progressive Association Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Vasiliki I Peppa
- Department of Physiology, Faculty of Medicine, BIOPOLIS, University of Thessaly Larissa, Greece
| | - Konstantinos Leivaditis
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, School of Medicine, American Hellenic Educational Progressive Association Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Theodoros Eleftheriadis
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, School of Medicine, American Hellenic Educational Progressive Association Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Sotirios G Zarogiannis
- Department of Physiology, Faculty of Medicine, BIOPOLIS, University of Thessaly Larissa, Greece
| | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, School of Medicine, American Hellenic Educational Progressive Association Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece
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Is there a role for intraperitoneal administration of heparin in hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis of colorectal cancer origin? Current data and future orientations. Med Hypotheses 2013; 81:240-2. [PMID: 23680001 DOI: 10.1016/j.mehy.2013.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 04/16/2013] [Accepted: 04/23/2013] [Indexed: 11/20/2022]
Abstract
In experimental studies, the intraperitoneal administration of heparin has been shown to attenuate cancer growth, reduce the formation of postoperative adhesions and possess immunomodulatory properties of oncological benefit for peritoneal carcinomatosis of colorectal cancer origin. Combined with data suggesting that the intraperitoneal administration of heparin can reduce the permeability and increase the ultrafiltration of the peritoneal membrane, we hypothesize that intraperitoneally administrated heparin could be a useful adjunction to the currently used hyperthermic intraperitoneal chemotherapy (HIPEC) regimens.
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Abstract
Functional deterioration of the peritoneal membrane in patients on peritoneal dialysis has been described as being the result of a combination of neoangiogenesis and fibrosis. Glucose, glucose degradation products, and the unphysiological pH of the dialysate solution contribute to these changes. Although newer solutions clearly perform better in terms of their biocompatibility in an in vitro setting and in animal models, the benefit of such solutions over older solutions in the clinical setting is so far unproven. The difficulties in showing a benefit of the newer, more biocompatible solutions in the clinical setting can be explained by the fact that other factors also affect the properties of the peritoneal membrane. These factors are often neglected in clinical studies, which results in unnoticed differences in case-mix and blurs the potential impact of the novel solutions. However, many of these factors are modifiable, and attention should be paid to them in clinical practice to maintain the integrity of the peritoneal membrane. This Review focuses on factors that potentially influence the integrity of the peritoneal membrane, other than those associated with the peritoneal dialysis fluid itself.
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Pletinck A, Van Landschoot M, Steppan S, Laukens D, Passlick-Deetjen J, Vanholder R, Van Biesen W. Oral supplementation with sulodexide inhibits neo-angiogenesis in a rat model of peritoneal perfusion. Nephrol Dial Transplant 2011; 27:548-56. [DOI: 10.1093/ndt/gfr370] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Affiliation(s)
- Peter Margetts
- Division of Nephrology, St. Joseph's Hospital Department of Medicine, McMaster University Hamilton, Ontario, Canada
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Zweers MM, Struijk DG. Mystery in the Dark: Can Antibiotic Prophylaxis Enlighten Us? Perit Dial Int 2006. [DOI: 10.1177/089686080602600212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Dirk G. Struijk
- Renal Unit Academic Medical Center The Netherlands
- University of Amsterdam Dianet Foundation Utrecht-Amsterdam The Netherlands
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