title: Catheter patency and peritoneal morphology and function in a rat model of citrate-buffered peritoneal dialysis.
abstract: BACKGROUND
  Single-dwell studies in rats and humans have shown that supplementing citrate for lactate in peritoneal dialysis (PD) fluids improves ultrafiltration (UF). ♢
  
  
  METHODS
  The long-term effects of citrate-substituted PD fluids on PD catheter patency, UF, and peritoneal morphology were evaluated in a rat model over 5 weeks of daily PD fluid exposure. A standard 2.5% glucose 40 mmol/L lactate PD fluid and a corresponding 10/30 mmol/L citrate/lactate PD fluid were compared. In a control group, rats with catheters received no PD fluid. ♢
  
  
  RESULTS
  The average patency time (% of 36 days) of silicone rubber PD catheters was significantly longer in the citrate PD group (98.8% ± 1.2%) and the control group (100% ± 0%) compared to the lactate PD group (54.7% ± 9.5%). In a separate experiment, heparin-coated polyurethane catheters were used to study peritoneal morphology and fluid transport. The citrate group had a higher net UF than the lactate group at the beginning and at the end of the 5 weeks. During the experiment, both fluid-treated groups suffered from UF loss; the control group showed the highest net UF at the end of the 5 weeks. Peritoneal vascular density and submesothelial thickness, indicators of angiogenesis and fibrosis, were not significantly different among the groups. Fibrosis was significantly negatively correlated to osmotic UF. ♢
  
  
  CONCLUSIONS
  A positive acute effect of citrate on UF was confirmed and conserved over time. Citrate PD strongly improved PD catheter patency time compared with lactate. Both citrate PD and lactate PD induced negative long-term effects on UF compared with control animals.
authors.affiliation: Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Nicola
authors.initials: N
authors.lastname: Cavallini
authors.forename: Magnus
authors.initials: M
authors.lastname: Braide
mesh_terms: D000818:Animals; D000925:Anticoagulants / Q000737:chemistry; D001692:Biological Transport; D002021:Buffers; D002408:Catheters, Indwelling; D002951:Citrates / Q000008:administration & dosage* / Q000493:pharmacokinetics; D020099:Coated Materials, Biocompatible / Q000737:chemistry; D015314:Dialysis Solutions / Q000008:administration & dosage*; D004848:Epithelium / Q000033:anatomy & histology; D004867:Equipment Design; D005355:Fibrosis; D005947:Glucose / Q000008:administration & dosage; D006493:Heparin / Q000737:chemistry; D019344:Lactic Acid / Q000008:administration & dosage / Q000493:pharmacokinetics; D008297:Male; D008643:Mesentery / Q000033:anatomy & histology; D055806:Microvessels / Q000033:anatomy & histology; D023421:Models, Animal; D018919:Neovascularization, Physiologic / Q000502:physiology; D009852:Omentum / Q000033:anatomy & histology; D010530:Peritoneal Dialysis / Q000379:methods*; D010537:Peritoneum / Q000033:anatomy & histology* / Q000098:blood supply / Q000378:metabolism; D011140:Polyurethanes / Q000737:chemistry; D051381:Rats; D017207:Rats, Sprague-Dawley; D012826:Silicone Elastomers / Q000737:chemistry; D013997:Time Factors; D014462:Ultrafiltration / Q000379:methods
chemical_list: D000925:Anticoagulants; D002021:Buffers; D002951:Citrates; D020099:Coated Materials, Biocompatible; D015314:Dialysis Solutions; D011140:Polyurethanes; D012826:Silicone Elastomers; D019344:Lactic Acid; D006493:Heparin; D005947:Glucose