Influence of Renin-Angiotensin-Aldosterone System-Blocking Drugs on Peritoneal Membrane in Peritoneal Dialysis Patients
| Autor: | Silvan Saksida, Dimitrij Klančič, Andrej Guček, Jernej Pajek, Andrej Drozg, Robert Ekart, Igor Rus, Alijana Trošt Rupnik, Marjeta Lesnik, Andrej Bren, Damjan Kovač, Simona Lopert, Jelka Lindič, Joško Osredkar, Zala Plešivčnik, Mateja Globokar |
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| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Aldosterone business.industry medicine.medical_treatment Angiotensin III Hematology Peritoneal equilibration test Angiotensin II Peritoneal dialysis Vascular endothelial growth factor chemistry.chemical_compound Endocrinology chemistry Nephrology Internal medicine Renin–angiotensin system medicine business Peritoneal Fibrosis |
| Zdroj: | Therapeutic Apheresis and Dialysis. 17:425-430 |
| ISSN: | 1744-9979 |
| DOI: | 10.1111/1744-9987.12091 |
| Popis: | Therapy with renin-angiotensin-aldosterone system (RAAS)-blocking drugs prevents the development of fibrosis and angiogenesis in animal models and humans. In our study we have evaluated the systemic effect of RAAS blockade and the effect on peritoneal growth factors, cytokine production and membrane transport characteristics in patients on peritoneal dialysis. Thirty-seven peritoneal dialysis (PD) patients were enrolled in our cross-sectional study. Aldosterone and angiotensin II concentrations were measured in serum to determine the RAAS activity. The inflammatory and profibrotic activity was evaluated by measuring the concentration of C-reactive protein (CRP), serum albumin, and peritoneal concentration of interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), plasminogen activator inhibitor-1 (PAI-1), transforming growth factor-β (TGF-β) and cancer antigen-125 (CA-125). The transport characteristics of the peritoneal membrane were analyzed with a peritoneal equilibration test (PET). Results were compared between the group with RAAS-blocking drugs (RAAS group) and the group without them (non-RAAS group). Mean serum aldosterone concentration was significantly lower in patients treated with ARB-blocking drugs (P = 0.001) and serum angiotensin II concentration was lower in patients treated with ACE inhibitors (P = 0.009). RAAS blockade resulted in lower peritoneal PAI-1 levels (748.1 to 1222.7 ng/L; P = 0.07) without any influence on CRP, peritoneal concentrations of IL-6, VEGF, TGF-β and CA-125, or alteration in peritoneal membrane characteristics tested by PET. RAAS-blocking drugs could be effective in preventing peritoneal fibrosis due to possible reduction of peritoneal PAI-1 concentrations that have already been etiologically linked with fibrin deposition in the pathogenesis of encapsulating peritoneal sclerosis. |
| Databáze: | OpenAIRE |
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