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Abstract: TH-PO287

Cardiovascular Effects of Peritoneal Dialysis in a Uremic Rat Model

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Nasci, Victoria L., Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Goodreau, Kathryn A., Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Kriegel, Alison J., Medical College of Wisconsin, Milwaukee, Wisconsin, United States
Background

In the US more than 700,000 people suffer from end stage renal disease (ESRD) of which 97.5% are reliant on dialysis. Among dialysis patients, cardiovascular (CV) related events are the leading cause of death. Despite therapeutic advancements the continued CVD following the onset of dialysis poses an interesting clinical challenge that necessitates further studies into the effects and effectiveness of dialysis. Based on clinical outcomes, we hypothesized that peritoneal dialysis (PD) would have no effect on CV outcomes in the 5/6 nephrectomy (5/6Nx) rat model.

Methods

We performed 5/6Nx (n=13), or sham surgery (n=10), on 10 week old male Sprague-Dawley rats. Peritoneal catheters were implanted 6 weeks post-surgery. PD was initiated 2 days later in some of the 5/6Nx (n=6) and sham (n=5) animals (15ml [Baxter PD-2 2.5%] 1-hour dwell 3x/day x7days). Echocardiography was performed at baseline, 6, and 7 weeks post-surgery. At week 7 pressure volume analysis was performed prior to serum and tissue collection. Statistical significance was determined by two-way ANOVA.

Results

Blood urea nitrogen (BUN) was increased by 5/6Nx (5/6Nx 41.57±2.78 vs. sham 20.25±0.48; p<0.05). PD had no effect on BUN in sham animals, but decreased BUN in 5/6Nx (5/6Nx 41.57±2.78 vs. 5/6Nx+PD 31.5±1.48; p<0.05). PD had no effect on serum sodium, potassium, or bicarbonate levels, nor did it effect serum cholesterol. PD had no effect on albumin excretion in both sham and 5/6Nx animals. PD did not alter kidney weight in sham animals, but reduced remnant kidney weight in 5/6Nx (5/6Nx 0.49±0.03 vs. 5/6Nx+PD 0.39±0.01; p<0.05). 5/6Nx increased heart weight (5/6Nx 0.42±0.02 vs. 0.35±0.01; p<0.05). PD had no effect on heart weight in sham animals, but attenuated the increase in 5/6Nx (5/6Nx 0.42±0.02 vs. 0.39±0.02; p=0.08). PD had no effect on CV functional parameters in sham animals and in 5/6Nx neither improved nor worsened CV outcomes.

Conclusion

These data combined suggests that PD may reduce renal pathology by reducing stress on remaining functional nephrons. Importantly, we did not observe an improvement in CV parameters with PD, which is consistent with persistent CV risk in the PD population. These findings indicate this is an appropriate model for future studies focused on improving dialysis efficacy and CV outcomes for ESRD patients.

Funding

  • Other NIH Support