NDT Advance Access originally published online on February 19, 2004
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Nephrol Dial Transplant (2004) 19: 1264-1268
Nephrol Dial Transplant Vol. 19 No. 5 © ERA-EDTA 2004; all rights reserved
Original Article
Intraperitoneal heparin reduces peritoneal permeability and increases ultrafiltration in peritoneal dialysis patients
1Department of Clinical Biochemistry and 2Department of Nephrology, Ribe County Hospital in Esbjerg/Varde and 3Department for Thrombosis Research, University of Southern Denmark, Denmark
Correspondence and offprint requests to: Jonas Angel Sjøland, MD, Department of Clinical Biochemistry, Ribe County Hospital in Esbjerg/Varde, Finsensgade 35, DK-6700 Esbjerg, Denmark. Email: jasj{at}ribeamt.dk
Background. Patients on long-term treatment with peritoneal dialysis (PD) suffer from increasing peritoneal permeability and loss of ultrafiltration as a result of persistent inflammation, which may be triggered by bioincompatible dialysis fluids. Heparins have anti-inflammatory and anticoagulant properties. We have examined the effect of intraperitoneal (IP) low-molecular weight heparin (tinzaparin) on peritoneal permeability and ultrafiltration in PD patients.
Methods. By means of a double-blinded cross-over design, 21 PD patients were randomized to receive either placebo or tinzaparin intraperitoneally once a day for two treatment periods of 3 months, separated by a wash-out period. The effect of heparin on peritoneal permeability and ultrafiltration was assessed using the 4 h standard peritoneal equilibration test.
Results. IP tinzaparin reduced significantly the dialysate-to-plasma ratios (D/P) of creatinine (P < 0.01), urea (P < 0.01) and albumin (P<0.05). In addition, the ratio of glucose concentration in dialysate at 4 h dwell to that of 0 h dwell (D4/D0) was increased (P<0.05) along with an increase in ultrafiltration volume (P<0.05).
Conclusions. IP tinzaparin reduces peritoneal permeability to small solutes and increases ultrafiltration in PD patients.
Keywords: heparin; intraperitoneal administration; peritoneal dialysis; peritoneal transport; ultrafiltration
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