title: Effects of renin-angiotensin-aldosterone system blockade on chlorhexidine gluconate-induced sclerosing encapsulated peritonitis in rats.
abstract: Sclerosing encapsulated peritonitis (SEP) is a rare complication of long term peritoneal dialysis. Renin-angiotensin-aldosterone system (RAAS) may play a role in the development of peritoneal fibrosis in CAPD patients. We aimed to evaluate the effect of aliskiren, valsartan, and aliskiren + valsartan therapy on SEP. The study included 30 Wistar albino rats which were divided into five groups: I (Control) SF solution i.p.; II (CG group) chlorhexidine gluconate i.p.; III aliskiren oral plus CG i.p.; IV valsartan oral plus CG i.p.; and V aliskiren oral, valsartan oral and CG i.p. On the twenty-first day, all of the rats were sacrificed. All of the groups were analyzed in terms of peritoneal thickness, degree of inflammation, vasculopathy, neovascularization and fibrosis. Also, the parietal peritoneal tissue samples were evaluated for matrix metalloproteinase 2 (MMP-2) using the ELISA method. Peritoneal thickness and fibrosis scores were lower in the valsartan group compared to the CG group (P < 0.05). Peritoneal fibrosis scores were lower in the aliskiren group compared to CG group (P < 0.05) but no difference was observed between the peritoneal thickness scores of the two groups (P > 0.05). Tissue MMP-2 levels were significantly higher in the CG group compared other groups (P < 0.05). There were no statistically significant differences between the aliskiren, valsartan and aliskiren + valsartan groups according to the tissue MMP-2 levels. Due to the antifibrotic properties of valsartan, it is thought to be a possible choice to prevent SEP development. We found no positive impact of aliskiren or aliskiren + valsartan combination compared to valsartan alone.
authors.affiliation: Department of Nephrology Pathology General Surgery, Ankara Education and Research Hospital, Ankara, Turkey. gulaykad@hotmail.com
authors.forename: Gülay
authors.initials: G
authors.lastname: Koçak
authors.forename: Alper
authors.initials: A
authors.lastname: Azak
authors.forename: Hesna Müzeyyen
authors.initials: HM
authors.lastname: Astarcı
authors.forename: Bülent
authors.initials: B
authors.lastname: Huddam
authors.forename: Gökhan
authors.initials: G
authors.lastname: Karaca
authors.forename: Mevlüt
authors.initials: M
authors.lastname: Ceri
authors.forename: Murat
authors.initials: M
authors.lastname: Can
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sert
authors.forename: Murat
authors.initials: M
authors.lastname: Duranay
mesh_terms: D000577:Amides / Q000494:pharmacology*; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology*; D000818:Animals; D002710:Chlorhexidine / Q000031:analogs & derivatives; D005650:Fumarates / Q000494:pharmacology*; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism; D010537:Peritoneum / Q000473:pathology; D010538:Peritonitis / Q000139:chemically induced / Q000378:metabolism / Q000473:pathology*; D051381:Rats; D017208:Rats, Wistar; D012084:Renin-Angiotensin System / Q000187:drug effects*; D013777:Tetrazoles / Q000494:pharmacology*; D014633:Valine / Q000031:analogs & derivatives* / Q000494:pharmacology; D000068756:Valsartan; D000092502:Renin Inhibitors
chemical_list: D000577:Amides; D047228:Angiotensin II Type 1 Receptor Blockers; D002710:Chlorhexidine; D005650:Fumarates; D020778:Matrix Metalloproteinase 2; D013777:Tetrazoles; D014633:Valine; D000068756:Valsartan; D000092502:Renin Inhibitors; C446481:aliskiren; C010882:chlorhexidine gluconate