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Kidney Week

Abstract: SA-PO716

A Strategy for the Simultaneous Preservation of Residual Renal Function and Peritoneal Structure/Function

Session Information

  • Peritoneal Dialysis - II
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

  • 608 Peritoneal Dialysis

Authors

  • Miyata, Kana N., Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, United States
  • Zhang, Pei, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, United States
  • Adler, Sharon G., Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, United States
  • La page, Janine A., Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, United States
  • Dai, Tiane, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, United States
Background

Residual renal function (RRF) preservation is key to maintaining peritoneal dialysis (PD) long-term. In a separate abstract, we showed that in rats with polycystic kidneys (PCK), the peritoneal fibrosis and functional decline due to 16 wks of dialysate infusion with 4.25% Dianeal was attenuated by the intraperitoneal administration of Losartan and/or Ruxolitinib (JAK1/2 inhibitor). Here, we investigated their effects on renal function.

Methods

Tunneled PD catheters were placed in PCK rats who received BID infusions of normal saline, 4.25% Dianeal, 4.25% Dianeal + Ruxolitinib (5mg/kg), 4.25% Dianeal + Losartan (5mg/kg), or 4.25% Dianeal + Losartan + Ruxolitinib for 16 weeks. Control group did not receive a catheter or PD fluid. We measured tail cuff mean arterial pressure (MAP), BUN, 24h urine protein-to-creatinine ratio (UPCR), urine albumin-to-creatinine ratio (UACR), and total kidney/body weight ratio(KW/BW). Results were evaluated by one-way ANOVA followed by the Tukey test. Values were expressed as mean± SEM.

Results

PCK rats (fibrocystin mutation) develop proteinuria, albuminuria, cystic tubulointerstitial disease, and progressive GFR decline. UPCR, UACR, and MAP were significantly lower in groups given Losartan compared to those without Losartan. BUN rise was lowest in the Dianeal alone and Losartan groups. Ruxolitinib did not significantly affect measured parameters. None of the interventions altered KW/BW ratio.
Summary: In PCK rats, Dianeal intraperitoneal infusions alone or with Losartan attenuated a rise in BUN. Losartan also reduced UPCR, UACR, and MAP, but not KW/BW. Ruxolitinib did not significantly alter renal parameters.

Conclusion

Taken together with our work on peritoneal structure/function in this PCK model, Losartan alone, or Losartan in combination with Ruxolitinib, offer the possibility of maintaining peritoneal structure and function and RRF while reducing proteinuria. Strategies that maintain both peritoneal and renal structure and function may enhance PD technique survival.

Funding

  • Other NIH Support