title: The effects of irbesartan and spironolactone in prevention of peritoneal fibrosis in rats.
abstract: BACKGROUND
  Bacterial peritonitis episodes may disturb the functional and histological integrity of the peritoneum in peritoneal dialysis patients. The renin-angiotensin-aldosterone system may have fibrotic effects on the peritoneum.
  
  
  OBJECTIVE
  To study the effects of an angiotensin II receptor antagonist (irbesartan) and an aldosterone antagonist (spironolactone) in the prevention of peritoneal fibrosis in a rat model of bacterial peritonitis.
  
  
  METHODS
  40 Wistar rats were randomized into 5 groups: bacteria (B), bacteria-irbesartan (BI), bacteria-spironolactone (BS), bacteria-irbesartan-spironolactone (BIS), and control (C) groups. The C group received only dextran beads (Cytodex; Sigma Chemicals, St Louis, Missouri, USA); the others were given bacteria and dextran beads intraperitoneally. Irbesartan and/or spironolactone were given to 3 groups: BI, BS, and BIS. On the eighth day, the rats were sacrificed, peritoneal adhesion was quantified, and peritoneal tissue sections were evaluated histologically.
  
  
  RESULTS
  The peritoneal total adhesion score was significantly higher in the B group than in the BI, BIS, and C groups (p < 0.01). Mean peritoneal thickness, mean inflammation score, and mean fibrosis score were significantly higher in the B group in comparison to the C group (p < 0.05). Mean peritoneal thickness of all treatment groups was significantly lower than the B group (p < 0.05). Serum transforming growth factor beta-1 level was significantly higher in the B group than in the BI, BS, and C groups (p < 0.05).
  
  
  CONCLUSIONS
  Irbesartan and spironolactone seem to decrease the extent of peritoneal injury caused by bacterial peritonitis.
authors.affiliation: Department of Nephrology, Dokuz Eylül University Medical School, Izmir, Turkey. uzmanersoy@yahoo.com
authors.forename: Rifki
authors.initials: R
authors.lastname: Ersoy
authors.forename: Ali
authors.initials: A
authors.lastname: Celik
authors.forename: Osman
authors.initials: O
authors.lastname: Yilmaz
authors.forename: Sulen
authors.initials: S
authors.lastname: Sarioglu
authors.forename: Banu
authors.initials: B
authors.lastname: Sis
authors.forename: Pinar
authors.initials: P
authors.lastname: Akan
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Yenicerioglu
authors.forename: Murat
authors.initials: M
authors.lastname: Ormen
authors.forename: Taner
authors.initials: T
authors.lastname: Camsari
mesh_terms: D000284:Administration, Oral; D000804:Angiotensin II; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage* / Q000493:pharmacokinetics; D000818:Animals; D001713:Biphenyl Compounds / Q000008:administration & dosage* / Q000493:pharmacokinetics; D004232:Diuretics / Q000008:administration & dosage* / Q000493:pharmacokinetics; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay; D005355:Fibrosis; D000077405:Irbesartan; D010532:Peritoneal Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D010533:Peritoneal Lavage; D010537:Peritoneum / Q000378:metabolism; D010538:Peritonitis / Q000150:complications / Q000382:microbiology; D051381:Rats; D012720:Severity of Illness Index; D013148:Spironolactone / Q000008:administration & dosage* / Q000493:pharmacokinetics; D013203:Staphylococcal Infections / Q000150:complications / Q000382:microbiology; D013211:Staphylococcus aureus / Q000472:pathogenicity; D013777:Tetrazoles / Q000008:administration & dosage* / Q000493:pharmacokinetics; D053773:Transforming Growth Factor beta1 / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001713:Biphenyl Compounds; D004232:Diuretics; D013777:Tetrazoles; D053773:Transforming Growth Factor beta1; D000804:Angiotensin II; D013148:Spironolactone; D000077405:Irbesartan