Effects of intraperitoneal hyaluronan on peritoneal fluid and solute transport in @entity298 XXXX .

@entity1 @entity32 @entity8273 @entity1133 @entity1372 @entity413 @entity1011 @entity35 @entity298
BACKGROUND: @entity8273 ( @entity8273 ) is a glycosaminoglycan found in connective tissues and tissue spaces, including the peritoneal cavity. In vivo studies in a @entity35 model of @entity298 ( @entity298 ) have shown that addition of @entity8273 to @entity298 solution during an intraperitoneal dwell can alter peritoneal fluid transport and protect the peritoneal membrane from the effects of @entity32 and repeated infusions of dialysis solution. The current study sought to evaluate the safety of intraperitoneal @entity8273 and its effect on peritoneal fluid and solute transport when administered during a dialysis dwell in @entity1 . METHODS: 13 @entity298 @entity1 were enrolled in a prospective, randomized crossover study involving three dialysis treatments using the following @entity298 solutions: (1) a commercially available @entity298 solution (Dianeal @entity298 -4, 1.36% @entity413 ; Baxter Healthcare Corporation, Alliston, Ontario, Canada); (2) Dianeal @entity298 -4 containing 0.1 g/L @entity8273 , and (3) Dianeal @entity298 -4 containing 0.5 g/L @entity8273 . Each 6-hour dialysis exchange was separated from the other exchanges by a 2-week washout period. Radioiodinated human serum albumin (RISA) was administered with the dialysis solution to evaluate intraperitoneal volume, net ultrafiltration (UF), and fluid reabsorption. Peritoneal clearances, dialysate/plasma ratios (D/P), and mass transfer area coefficients (MTACs) were determined for @entity1372 , @entity1133 , @entity1011 , albumin, and @entity413 . Safety was evaluated by monitoring adverse events and changes in serum chemistries. Ten @entity1 completed all three dialysis exchanges and two additional @entity1 completed at least one treatment exchange. RESULTS: There were no reported adverse events related to @entity8273 administration and no significant changes in serum chemistries. There were no significant differences in net UF or peritoneal volume profiles among the three treatments. Mean net UF calculated using residual volumes, estimated by RISA dilution, tended to be slightly higher during treatment with solution containing 0.1 g/L @entity8273 and 0.5 g/L @entity8273 [74 +/- 86 (SE) and 41 +/- 99 mL, respectively] compared to control treatment (-58 +/- 129 mL). Although not statistically significant, there was a trend toward decreased fluid reabsorption during treatment with @entity8273 . Solute clearances, D/P ratios, and MTACs were similar for the three treatments. Serum levels of @entity8273 were also unaffected by the two treatment solutions. CONCLUSIONS: These data support the acute safety of @entity8273 when administered intraperitoneally with the dialysis solution to @entity298 @entity1 . Due to the small sample size and variability in net UF and fluid reabsorption, statistically significant differences were not demonstrated for these parameters. However, a trend toward decreased fluid reabsorption was observed, suggesting that @entity8273 may act by a mechanism similar to that observed in animal studies. Further studies are necessary to evaluate whether the beneficial effects of @entity8273 observed in animal studies can be shown in @entity1 .
