Intraperitoneal heparin reduces peritoneal permeability and increases ultrafiltration in peritoneal dialysis patients.
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 (D(4)/D(0)) 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.
Department of Clinical Biochemistry, Ribe County Hospital in Esbjerg/Varde, and Department for Thrombosis Research, University of Southern Denmark, Denmark. jasj@ribeamt.dk
Jonas Angel
JA
Sjøland
Robert
R
Smith Pedersen
Jørgen
J
Jespersen
Jørgen
J
Gram
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D010530:Peritoneal Dialysis; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010537:Peritoneum / Q000503:physiopathology*; D010539:Permeability; D010976:Platelet Count; D000078222:Tinzaparin
D001786:Blood Glucose; D006495:Heparin, Low-Molecular-Weight; D000078222:Tinzaparin; D006493:Heparin