Journal Article

Intraperitoneal heparin reduces peritoneal permeability and increases ultrafiltration in peritoneal dialysis patients

Jonas Angel Sjøland, Robert Smith Pedersen, Jørgen Jespersen and Jørgen Gram

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 19, issue 5, pages 1264-1268
Published in print May 2004 | ISSN: 0931-0509
Published online February 2004 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfh065
Intraperitoneal heparin reduces peritoneal permeability and increases ultrafiltration in peritoneal dialysis patients

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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

Journal Article.  2796 words.  Illustrated.

Subjects: Nephrology

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