title: Development and evaluation of a retroperitoneal dialysis porcine model.
abstract: OBJECTIVE
  We attempted to create a surgical model to evaluate the retroperitoneal space for the ability to transfer solutes through the retroperitoneal membrane. Our dual objectives were to develop a technique to assess the feasibility of retroperitoneal dialysis (RPD) in a porcine model.
  
  
  METHODS
  We incorporated two 35-kg Yorkshire pigs for this pilot study. In the first animal, we clamped renal vessels laparoscopically. In the second animal, we embolized renal arteries. In both animals, we dilated the retroperitoneal space bilaterally and deployed dialysis catheters. We measured serum creatinine (Cr), urea, and electrolytes at baseline 6 hours before the dialysis and every 4 hours after.
  
  
  RESULTS
  We successfully created retroperitoneal spaces bilaterally and deployed dialysis catheters in both animals. In the first animal, dialysate and plasma Cr ratio (D/P) on the left and right side were 0.43 and 0.3, respectively. Cr clearance by 40 minutes of dialysis treatment was 6.3 mL/min. The ratio of dialysate glucose at 4 hours dwell time to dialysate glucose at 0 dwell time (D/D0) for left/rights sides were 0.02 and 0.02, respectively. kt/Vurea was 0.43. In the second animal, D/P Cr for left/right sides were 0.34 and 0.33, respectively. kt/Vurea was 0.17. We euthanized the pigs due to fluid collection in the peritoneal space and rapid increase of serum Cr, urea, and electrolytes.
  
  
  CONCLUSIONS
  We demonstrated the feasibility of creation of a functionally anephric porcine model with successful development of retroperitoneal spaces using balloon inflation. Notwithstanding minimal clearance and limited diffusion capacity in this experiment, additional studies are needed to examine potential use of retroperitoneal space for peritoneal dialysis.
authors.forename: Zhamshid
authors.initials: Z
authors.lastname: Okhunov
authors.forename: Renai
authors.initials: R
authors.lastname: Yoon
authors.forename: Alberto
authors.initials: A
authors.lastname: Perez Lanzac
authors.forename: Michael
authors.initials: M
authors.lastname: Sgroi
authors.forename: Wei Ling
authors.initials: WL
authors.lastname: Lau
authors.forename: Michael
authors.initials: M
authors.lastname: Del Junco
authors.forename: Michael
authors.initials: M
authors.lastname: Ordon
authors.forename: Austin
authors.initials: A
authors.lastname: Drysch
authors.forename: Christina
authors.initials: C
authors.lastname: Hwang
authors.forename: Simone L
authors.initials: SL
authors.lastname: Vernez
authors.forename: Roy
authors.initials: R
authors.lastname: Fujitani
authors.forename: Nii-Kabu
authors.initials: NK
authors.lastname: Kabutey
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
authors.forename: Jaime
authors.initials: J
authors.lastname: Landman
mesh_terms: D000818:Animals; D003404:Creatinine / Q000097:blood*; D004195:Disease Models, Animal; D005260:Female; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D010530:Peritoneal Dialysis; D010865:Pilot Projects; D013552:Swine
chemical_list: D003404:Creatinine