Serum levels of nitric oxide and endothelin-1 in patients treated with continuous ambulatory peritoneal dialysis

Renal Failure ◽  
2013 ◽  
Vol 36 (3) ◽  
pp. 437-440 ◽  
Author(s):  
Pedja Kovačević ◽  
Saša Dragić ◽  
Zvezdana Rajkovača ◽  
Slavimir Veljković ◽  
Tijana Kovačević
Keyword(s):  
Nitric Oxide ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Serum Levels ◽  
Endothelin 1

The Pharmacokinetics of a Single Dose of Calcitriol Administered Subcutaneously in Continuous Ambulatory Peritoneal Dialysis Patients

1993 ◽  
Vol 13 (2) ◽  
pp. 122-125 ◽  
Author(s):  
Rafael Selgas ◽  
Maria-E. Martinez ◽  
Blanca Miranda ◽  
Maria-Auxiliadara Baja ◽  
Jase-Raman Ramera ◽  
...  
Keyword(s):  
Single Dose ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Plasma Levels ◽  
Subcutaneous Administration ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Mean Value ◽  
Ionized Calcium ◽  
Kinetics Of

Objectives To evaluate the kinetics of calcitriol (1,25(OH)2D3) administered subcutaneously. Study Design Calcitriol kinetics and efficacy after subcutaneous administration were studied in 13 CAPD patients with varying degrees of increased plasma levels of parathyroid hormone (i-PTH). A single dose of 2 μg of calcitriol was administered subcutaneously, and its serum levels at baseline and after 1,2,6,12, and 24 hours were determined. Plasma ionized calcium and i-PTH were also determined at these periods. Results Serum calcitriol levels reached peak levels of 60 and 70 pg/mL at 1 and 2 hours after administration, respectively. These levels decreased thereafter, but remained above baseline values during 24 hours. The mean value of the area under the curve (AUC) was 809±226 pg/mL/hour. Plasma i-PTH levels showed a slight decrease after 1 and 2 hours, returning to baselime levels after this period. Plasma ionized calcium did not show significant changes during the study. A slight pain at the site of injection was mentioned by some patients. Conclusions The subcutaneous route for calcitriol administration achieves theoretically adequate plasma levels in continuous ambulatory peritoneal dialysis (CAPD) patients. This is important when paremteral administration of calcitriol is considered in the treatment of secondary hyperparathyroidism.

Residual Renal Function Affects Lipid Profile in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

1997 ◽  
Vol 17 (3) ◽  
pp. 243-249 ◽  
Author(s):  
Alexander Kagan ◽  
Eti Elimalech ◽  
Zvi Lerner ◽  
Aaron Fink ◽  
Yaacov Bar-Khayim
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Lipid Profile ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
Residual Renal Function ◽  
Lipoprotein Cholesterol ◽  
Group A ◽  
Group B

Objective To determine whether lipoprotein abnormalities associated with continuous ambulatory peritoneal dialysis (CAPD) are influenced by residual renal function (RRF). Design Open, non randomized prospective and com -parative study. Setting Single university teaching hospital dialysis unit and outpatient clinic. Patients Twenty adult patients on standard CAPD (1 -38 months) were divided into two groups: group A (RRF ≤ 0.8 mL/min, n = 10) and group B (RRF ≥ 1.1 mL/ min, n = 10). Patients in the two groups were matched for age, time on dialysis, body weight, body mass index, serum urea and albumin levels, peritoneal and urinary albumin losses, and peritoneal transport characteristics such as overnight 8hour peritoneal creatinine and β2-microglobulin clearances and overnight 8-hour effluent glucose concentrations. Results The degree of uremia in patients with preserved RRF (group B) was obviously lower than in patients with negligible RRF (group A), that is, patients in group B had significantly lower serum creatinine and β2-microglobulin levels and significantly higher weekly KTN than group A patients. Despite the prevalence of allele 4 of apolipoprotein E genotype in group A patients, their levels of serum total cholesterol, low-density lipoprotein cholesterol, lipoprotein (a) [Lp(a)], apolipoprotein B (ApoB), and apolipoprotein A1 (ApoA1) were significantly lower than those of patients with preserved RRF (group B). The two groups did not differ significantly in the serum levels of triglyceride or high-density lipoprotein cholesterol. Serum concentrations of Lp(a) and ApoA1, as well as ratios of ApoA1 to ApoB, were correlated significantly with RRF (r = 0.63, r = 0.51, and r = 0.61, respectively). Conclusions The findings suggest that RRF affects the lipid profile of CAPD patients, especially serum levels of cholesterol-rich lipoproteins.

scholarly journals Clear Correlation of Tetrahydrobiopterin with Nitric Oxide Bioavailability in Continuous Ambulatory Peritoneal Dialysis

2010 ◽  
Vol 30 (2) ◽  
pp. 96-97
Author(s):  
Seiichi Mochizuki ◽  
Aya Takayama ◽  
Tamaki Sasaki ◽  
Toyotaka Yada ◽  
Kousuke Endo ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Clear Correlation ◽  
Nitric Oxide Bioavailability

Vancomycin administration in continuous ambulatory peritoneal dialysis: The risk of ototoxicity

1998 ◽  
Vol 118 (4) ◽  
pp. 551-558 ◽  
Author(s):  
Balwant S. Gendeh ◽  
Alan G. Gibb ◽  
Nik S. Aziz ◽  
Norella Kong ◽  
Zaki M. Zahir
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Therapeutic Agent ◽  
Trough Level ◽  
Pure Tone Audiometry ◽  
Serum Levels ◽  
Pharmacokinetic Profile ◽  
Vancomycin Therapy ◽  
Serum Vancomycin ◽  
A Prospective Study

A prospective study was undertaken in 16 patients with chronic renal failure on continuous ambulatory peritoneal dialysis, with 22 episodes of peritonitis treated with vancomycin, a known ototoxic agent. Twelve patients had one episode each, and four had recurrent peritonitis. Each treatment course consisted of two infusions of vancomycin (30 mg/kg body weight) in 2 L of peritoneal dialysate administered at 6-day intervals. Serum vancomycin analyzed by enzyme immunoassay showed a mean trough level of 11.00 μg/ml on day 6 and mean serum levels of 33.8 and 38.6 μg/ml about 12 hours after administration on days 1 and 7, respectively. Similar levels, well within the therapeutic range, were encountered with repeated vancomycin therapy for recurrent episodes of peritonitis, suggesting that no changes occurred in the pharmacokinetic profile of the drug. Pure-tone audiometry, electronystagmography, and clinical assessment performed during each course of treatment showed no evidence of ototoxicity even on repeated courses of vancomycin therapy. The results suggest that vancomycin therapy when given in appropriate concentrations as a single therapeutic agent is both effective and safe. We believe, however, that van-comycin administered in combination with an aminoglycoside may produce ototoxic effects that may be greatly aggravated, possibly because of synergism.

Increased excretion of nitric oxide in exhaled air of patients with chronic renal failure

1999 ◽  
Vol 96 (1) ◽  
pp. 67-74 ◽  
Author(s):  
Akihiro MATSUMOTO ◽  
Yasunobu HIRATA ◽  
Masao KAKOKI ◽  
Daisuke NAGATA ◽  
Shin-ichi MOMOMURA ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Chronic Renal Failure ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Exhaled Nitric Oxide ◽  
Simultaneous Increase ◽  
Nitric Oxide Production ◽  
Oxide Production ◽  
Endogenous Nitric Oxide

Nitric oxide exerts multiple effects on renal function. It remains unclear whether endogenous nitric oxide production is increased or decreased in patients with chronic renal failure. To evaluate endogenous nitric oxide production in these patients we studied exhaled nitric oxide output by an ozone chemiluminescence method and plasma NO2-/NO3- levels by the Griess method in 40 patients with end-stage chronic renal failure who underwent regular continuous ambulatory peritoneal dialysis (n = 30) or haemodialysis (n = 10), and in 28 healthy subjects. Patients with chronic renal failure had a higher exhaled nitric oxide concentration [39±3 versus 19±1 parts per billion, (mean±S.E.M.), P< 0.0001], a greater nitric oxide output (177±11 versus 96±7 ;nl·min-1·m-2, P< 0.001) and a higher plasma NO2-/NO3- concentration (96±14 versus 33±4 ;μmol, P< 0.01) than controls. These values did not differ between patients on haemodialysis and those on continuous ambulatory peritoneal dialysis. Patients with chronic renal failure had significantly higher plasma concentrations of both interleukin-1β and interferon-γ than controls. The exhaled nitric oxide output did not correlate with plasma NO2-/NO3- or with peritoneal dialysate NO2-/NO3-, but plasma NO2-/NO3- correlated with dialysate NO2-/NO3- in patients who underwent continuous ambulatory peritoneal dialysis (r = 0.77, P< 0.01). Haemodialysis for 4 ;h acutely decreased plasma NO2-/NO3- (92±17 versus 50±8 ;μmol, P< 0.05) and cGMP concentration (16.5±4.3 versus 5.1±1.7 ;pmol/ml, P< 0.01), but did not decrease exhaled nitric oxide output. The increase in exhaled nitric oxide with the simultaneous increase in circulating cytokines suggests that nitric oxide synthase seems to be induced significantly in patients with chronic renal failure. Increased endogenous nitric oxide production may have a pathophysiological role in patients with uraemia.

scholarly journals Volume Stress-Induced Peritoneal Endothelin-1 Release in Continuous Ambulatory Peritoneal Dialysis

1999 ◽  
Vol 10 (12) ◽  
pp. 2585-2590
Author(s):  
STANISLAO MORGERA ◽  
SIMONE KUCHINKE ◽  
KLEMENS BUDDE ◽  
ANDREAS LUN ◽  
BERTHOLD HOCHER ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Peritoneal Membrane ◽  
Endothelin 1 ◽  
Target Values ◽  
Ultrafiltration Failure ◽  
Significant Difference ◽  
The Impact ◽  
Volume Stress

Abstract. In long-term peritoneal dialysis, functional deterioration of the peritoneal membrane is often associated with proliferative processes of the involved tissues leading to peritoneal fibrosis. In continuous ambulatory peritoneal dialysis (CAPD), failure to achieve target values for adequacy of dialysis is commonly corrected by increasing dwell volume; in case of ultrafiltration failure, osmolarity of the dialysate gets increased. In a prospective study, the impact of increasing dwell volume from 1500 ml to 2500 ml per dwell (volume trial) or changing the osmolarity of the dialysate from 1.36 to 3.86% glucose (hyperosmolarity trial) on the peritoneal endothelin-1 (ET-1) release was analyzed. ET-1 is known to exert significant proliferative activities on a variety of cell types leading to an accumulation of extracellular matrix. A highly significant difference in the cumulative peritoneal ET-1 synthesis was found between the low- and high-volume exchange, whereas differences in the hyperosmolarity setting were only moderate. Sixty minutes after initiating dialysis, the cumulative ET-1 synthesis was 2367 ± 1023 fmol for the 1500 ml versus 6062 ± 1419 fmol for the 2500 dwell (P < 0.0001) and 4572 ± 969 fmol versus 6124 ± 1473 fmol for the 1.36 and 3.86% glucose dwell (P < 0.05), respectively. In conclusion, increasing dwell volume leads to a strong activation of the peritoneal paracrine endothelin system. Because ET-1, apart from being a potent vasoactive peptide, contributes to fibrotic remodeling, this study indicates that volume stress-induced ET-1 release might contribute to structural alteration of the peritoneal membrane in long-term peritoneal dialysis.

Single and Multiple-Dose Kinetics of Ofloxacin in Patients on Continuous Ambulatory Peritoneal Dialysis (CAPD)

1989 ◽  
Vol 9 (4) ◽  
pp. 267-272 ◽  
Author(s):  
J. Passlick ◽  
R. Wonner ◽  
E. Keller ◽  
L. Essers ◽  
B. Grabensee
Keyword(s):  
Single Dose ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Multiple Dose ◽  
Serum Levels ◽  
Time Interval ◽  
Single Dose Study ◽  
Multiple Dose Study ◽  
Dose Study ◽  
Stage Renal Disease

To evaluate the pharmacokinetics of ofloxacin, a novel quinolon antibiotic, in patients with end-stage renal disease (ESRO) on continuous ambulatory peritoneal dialysis (CAPO), we investigated 6 patients in a single-dose study and 9 patients in a multiple-dose study, all without peritonitis. In the single-dose study, patients received 200 mg ofloxacin orally. Serum concentrations (Cmax) peaked at 3.1 ± 0.3 mg/L (x ± SEM), 1.6 ± 0.5 h after p. 0. administration of the drug. Elimination half-life ( t112) was 26.8 ± 2.5 h. Peritoneal clearance accounted for 10% of the total body clearance. After 5- h dwell time, ofloxacin concentrations in the dialysate were 1.5 ± 0.2 mg/L, which is above the MIC90 for most bacteria responsible for peritonitis in patients on CAPO. In the multiple dose study, 200 mg ofloxacin were administered twice, with a time interval of 12 h, followed by 200 mg for 9 days every morning. Mean trough serum levels were 2.6 ± 1.0 mg/L, mean peak concentrations were 4.1 ± 1.7 mg/L. Mean ofloxacin concentrations in the peritoneal effluent were 1.9 ± 0.9 mg/L. It is concluded that an oral loading dose of 400 mg on the first day and a maintenance dose of 200 mg ofloxacin/day does not lead to significant accumulation, even though the elimination by the peritoneal route is only small. The proposed dosing regimen could be an adequate therapy of peritonitis and exit-site infections in patients on CAPO since levels reached in the dialysate effluent are bactericidal. The clinical usefulness in the treatment of peritonitis has to be proven in further studies.

Procollagen Type-I in the Serum and Dialysate of Continuous Ambulatory Peritoneal Dialysis Patients

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 480-483 ◽  
Author(s):  
George E. Digenis ◽  
Nicholas v. Dombros ◽  
Mary Christophoraki ◽  
Irene Grapsa ◽  
Nicholas Savidis ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Serum Levels ◽  
Type I ◽  
Healthy Controls ◽  
Dialysis Patients ◽  
Peritoneal Fibrosis ◽  
Procollagen Type ◽  
Procollagen Type I ◽  
Calcium Phosphorus

Procollagen-1 carboxylterminal extension peptide (PICP) was determined In the serum and dialysate of 26 continuous ambulatory peritoneal dialysis (CAPD) patients and in the serum of 11 healthy controls. PICP serum levels were significantly higher in CAPD patients than in healthy controls (p<0.001). There was no correlation between serum PICP levels and those of calcium, phosphorus, magnesium, alkaline phosphatase, osteocalcin, and intact parathyroid hormone (IPTH). Serum and dialysate levels of osteocalcin and lPTH showed a significant correlation (p<0.001). The dialysate-to-serum PICP ratio in 21 patients was lower than 1.0. In the remaining 5 patients, however, the above ratio was higher than 1.0. We conclude that In CAPD patients serum PICP levels do not correlate with biochemical parameters of renal osteodystrophy. A dialysate-to-serum PICP ratio above 1.0 could implicate an increased local peritoneal fibro blastic activity and could be a useful marker of peritoneal fibrosis In CAPD.

EFFECTS OF HAEMODIALYSIS AND CONTINUOUS AMBULATORY PERITONEAL DIALYSIS ON NITRIC OXIDE SERUM CONCENTRATION IN PATIENTS WITH CHRONIC RENAL FAILURE

2008 ◽  
Vol 37 (2) ◽  
pp. 93-98
Author(s):  
Amela Matavulj ◽  
Pedja Kovacevic ◽  
Jasminko Huskic ◽  
Slavimir Veljkovic ◽  
Zvezdana Rajkovaca ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Chronic Renal Failure ◽  
Serum Concentration ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
No Production ◽  
Bleeding Tendency ◽  
Wide Range ◽  
Hemostatic Disorders

Introduction: Nitric oxide (NO) plays an important role in a wide range of physiologic and pathophysiological processes. A major mediator of endothelial function, NO regulates vasodilatory and antithrombotic actions in the vasculature and plays a role in reproductive functions, bronchodilation, bone formation, memory, insulin sensitivity, and gastrointestinal relaxation. Impaired NO bioactivity is strongly associated with endothelial dysfunction. NO, an L-arginine derivative, also exerts a variety of renal and extrarenal physiological and pathophysiological effects. It seems that NO synthetic pathway could have a key role in mediating the complex hemodynamic and hemostatic disorders associated to the progression of renal disease. It remains unclear whether endogenous NO production is increased or decreased in patients with chronic renal failure. The objective of this study was to present the effect of different dialysis treatment on NO serum concentration in patients with chronic renal failure.Patients and Methods: To evaluate endogenous NO production in these patients we studied plasma NO2 and NO3 levels (determined with the Griess method) in patients who underwent regular continuous ambulatory peritoneal dialysis or repeated haemodialysis and in healthy subjects. The study included 51 patients suffering from chronic renal failure and 30 healthy subjects.Results: Our results show that patients with chronic renal failure had a significantly higher NO serum concentration than controls. These values did not differ between patients on haemodialysis and those on continuous ambulatory peritoneal dialysis. NO serum concentration did not differ between female and male independently of the patient’s treatment.Discussion and Conclusion: From obtained results we can concluded that uremia is associated with excessive systemic NO release independently of the patient’s treatment. Alter (increase) NO synthesis may help to explain some pathological changes seen in uraemia such as bleeding tendency, a well-known complication of uremia and hemodialysis hypotension.

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