Background/Aims: Currently available rodent models of peritoneal sclerosis are not based on clinically relevant factors: renal failure in combination with exposure to bioincompatible fluids. Our aim was to develop a chronic peritoneal infusion model of peritoneal sclerosis in rats with renal failure. Methods: Male Wistar rats underwent a catheter implantation and a 70% nephrectomy. They were randomly divided into three peritoneal infusion groups: chlorhexidine gluconate/ethanol (CGE) + Dianeal (Baxter Healthcare, Castlebar, Ireland), CGE + buffer (Physioneal without glucose; Baxter, Nivelles, Belgium) and Dianeal alone. After 8 weeks a peritoneal permeability test was performed and omental tissue was obtained for morphometrics. Results: The CGE + Dianeal group (n = 6) and CGE + buffer (n = 6) group showed high peritoneal clearances of small solutes and proteins, ultrafiltration failure, impaired free water transport, severe fibrosis and high vessel counts, but the groups did not differ significantly. The Dianeal group (n = 6) showed significantly lower clearances of small solutes and proteins, normal ultrafiltration and sodium sieving, and significantly lower fibrosis scores and vessel counts. Conclusions: Abnormalities seen in peritoneal sclerosis can be induced in a peritoneal infusion model in rats with renal failure. However, the addition of a bioincompatible dialysis solution had no contributing role, probably because the effects were overruled by those of CGE.

1.
Ghandi VC, Humayun HM, Ing TS, Daugirdas JT, Jablokow VR, Iwatsuki S, Geis WP, Hano JE: Sclerotic thickening of the peritoneal membrane in maintenance peritoneal dialysis patients. Arch Intern Med 1980;140:1201–1203.
[PubMed]
2.
Kawanishi H, Watanabe H, Moriishi M, Tsuchiya S: Successful surgical management of encapsulating peritoneal sclerosis. Perit Dial Int 2005;25(suppl 4):S39–S47.
[PubMed]
3.
Hoff CM: Experimental animal models of encapsulating peritoneal sclerosis. Perit Dial Int 2005;25(suppl 4):S57–S66.
[PubMed]
4.
Park SH, Kim YL, Lindholm B: Experimental encapsulating peritoneal sclerosis models: pathogenesis and treatment. Perit Dial Int 2008;28(suppl 5):S21–S28.
[PubMed]
5.
Hirahara I, Umeyama K, Urakami K, Kusano E, Masunaga Y, Asano Y: Serial analysis of matrix metalloproteinase-2 in dialysate of rat sclerosing peritonitis models. Clin Exp Nephrol 2001;5:103–108.
6.
Io H, Hamada C, Ro Y, Ito Y, Hirahara I, Tomino Y: Morphological changes of peritoneum and expression of VEGF in encapsulated peritoneal sclerosis rat models. Kidney Int 2004;65:1927–1936.
[PubMed]
7.
Junor BJ, Briggs JD, Forwell MA, Dobbie JW, Henderson I: Sclerosing peritonitis-the contribution of chlorhexidine in alcohol. Perit Dial Bull 1985;5:101–104.
8.
Mackow RC, Winchester JF, Argy WP, Andrews PM, Fields PA, Bates S, Rakowski TA, Schreiner GE: Sclerosing encapsulating peritonitis in rats: an experimental study with intraperitoneal antiseptics. Contrib Nephrol. Basel, Karger, 1987, vol 57, pp 213–218.
[PubMed]
9.
Suga H, Teraoka S, Ota K, Komemushi S, Furutani S, Yamauchi S, Margolin S: Preventive effect of pirfenidone against experimental sclerosing peritonitis in rats. Exp Toxicol Pathol 1995;47:287–291.
[PubMed]
10.
Ishii Y, Sawada T, Shimizu A, Tojimbara T, Nakajima I, Fuchinoue S, Teraoka S: An experimental sclerosing encapsulating peritonitis model in mice. Nephrol Dial Transplant 2001;16:1262–1266.
[PubMed]
11.
Okada H, Inoue T, Kanno Y, Kobayashi T, Watanabe Y, Ban S, Neilson EG, Suzuki H: Selective depletion of fibroblasts preserves morphology and the functional integrity of peritoneum in transgenic mice with peritoneal fibrosing syndrome. Kidney Int 2003;64:1722–1732.
[PubMed]
12.
Yoshio Y, Miyazaki M, Abe K, Nishino T, Furusu A, Mizuta Y, Harada T, Ozono Y, Koji T, Kohno S: TNP-470, an angiogenesis inhibitor, suppresses the progression of peritoneal fibrosis in mouse experimental model. Kidney Int 2004;66:1677–1685.
[PubMed]
13.
Levine S, Saltzman A: Abdominal cocoon: an animal model for a complication of peritoneal dialysis. Perit Dial Int 1996;16:613–616.
[PubMed]
14.
Nakamoto H, Imai H, Ishida Y, Yamanouchi Y, Inoue T, Okada H, Suzuki H: New animal models for encapsulating peritoneal sclerosis – role of acidic solution. Perit Dial Int 2001;21(suppl 3):S349–S353.
[PubMed]
15.
Hirahara I, Kusano E, Yanagiba S, Miyata Y, Ando Y, Muto S, Asano Y: Peritoneal injury by methylglyoxal in peritoneal dialysis. Perit Dial Int 2006;26:380–392.
[PubMed]
16.
Mackow RC, Argy WP, Winchester JF, Rakowski TA, Fields PA, Rotellar C, Schreiner GE: Sclerosing encapsulating peritonitis in rats induced by long-term intraperitoneal administration of antiseptics. J Lab Clin Med 1988;112:363–371.
[PubMed]
17.
Fracasso A, Baggio B, Ossi E, Del Prete D, Bonfante L, Bazzato G, Gambaro G: Glycosaminoglycans prevent the functional and morphological peritoneal derangement in an experimental model of peritoneal fibrosis. Am J Kidney Dis 1999;33:105–110.
[PubMed]
18.
Komatsu H, Uchiyama K, Tsuchida M, Isoyama N, Matsumura M, Hara T, Fukuda M, Kanaoka Y, Naito K: Development of a peritoneal sclerosis rat model using a continuous-infusion pump. Perit Dial Int 2008;28:641–647.
[PubMed]
19.
Liu L, Shi CX, Ghayur A, Zhang C, Su JY, Hoff CM, Margetts PJ: Prolonged peritoneal gene expression using a helper-dependent adenovirus. Perit Dial Int 2009;29:508–516.
[PubMed]
20.
Margetts PJ, Kolb M, Galt T, Hoff CM, Shockley TR, Gauldie J: Gene transfer of transforming growth factor-β1 to the rat peritoneum: effects on membrane function. J Am Soc Nephrol 2001;12:2029–2039.
[PubMed]
21.
Williams JD, Craig KJ, Topley N, von Ruhland C, Fallon M, Newman GR, Mackenzie RK, Williams GT: Morphologic changes in the peritoneal membrane of patients with renal disease. J Am Soc Nephrol 2002;13:470–479.
[PubMed]
22.
Krediet RT, Zweers MM, van Westrhenen R, Zegwaard AH, Struijk DG: Effects of reducing the lactate and glucose content of PD solutions on the peritoneum. Is the future GLAD? NDT Plus 2008;1:iv56–iv62.
23.
De Graaff M, Zegwaard AH, Zweers MM, Vlijm A, de Waart DR, Vandemaele F, Struijk DG, Krediet RT: The effects of a dialysis solution with a combination of glycerol/amino acids/dextrose on the peritoneal membrane in chronic renal failure. Perit Dial Int 2010 (in press).
24.
Mortier S, De Vriese AS, Leyssens A, Vanacker NJ, Faict D, Cornelissen M, De Ridder L, Lameire NH: Antibiotic administration in an animal model of chronic peritoneal dialysate exposure. Perit Dial Int 2003;23:331–338.
[PubMed]
25.
Bazargani F, Albrektsson A, Yahyapour N, Braide M: Low molecular weight heparin improves peritoneal ultrafiltration and blocks complement and coagulation. Perit Dial Int 2005;25:394–404.
[PubMed]
26.
De Vriese AS, Mortier S, Lameire NH: Non-anticoagulant effects of heparin: implications for animal models of peritoneal dialysis. Perit Dial Int 2001;21(suppl 3):S354–S356.
[PubMed]
27.
Pawlaczyk K, Kuzlan-Pawlaczyk M, Anderstam B, Heimburger O, Bergstrom J, Waniewski J, Breborowicz A, Lindholm B: Effects of intraperitoneal heparin on peritoneal transport in a chronic animal model of peritoneal dialysis. Nephrol Dial Transplant 2001;16:669–671.
[PubMed]
28.
Schilte MN, Loureiro J, Keuning ED, Ter Wee PM, Celie JW, Beelen RH, van den Born J: Long-term intervention with heparins in a rat model of peritoneal dialysis. Perit Dial Int 2009;29:26–35.
[PubMed]
29.
Laouari D, Friedlander G, Burtin M, Silve C, Dechaux M, Garabedian M, Kleinknecht C: Subtotal nephrectomy alters tubular function: effect of phosphorus restriction. Kidney Int 1997;52:1550–1560.
[PubMed]
30.
Terzi F, Beaufils H, Laouari D, Burtin M, Kleinknecht C: Renal effect of antihypertensive drugs depends on sodium diet in the excision remnant kidney model. Kidney Int 1992;42:354–363.
[PubMed]
31.
Zweers MM, Splint LJ, Krediet RT, Struijk DG: Effect of fluid supplementation and modality on peritoneal permeability characteristics in a rat peritoneal dialysis model. Perit Dial Int 2001;21:58–64.
[PubMed]
32.
Smit W, van Dijk P, Langedijk MJ, Schouten N, van den Berg N, Struijk DG, Krediet RT: Peritoneal function and assessment of reference values using a 3.86% glucose solution. Perit Dial Int 2003;23:440–449.
[PubMed]
33.
Waniewski J, Heimburger O, Werynski A, Lindholm B: Simple models for fluid transport during peritoneal dialysis. Int J Artif Organs 1996;19:455–466.
[PubMed]
34.
Afthentopoulos IE, Passadakis P, Oreopoulus DG, Bargman J: Sclerosing peritonitis in continuous ambulatory peritoneal dialysis patients: one center’s experience and review of the literature. Adv Ren Replace Ther 1998;5:157–167.
[PubMed]
35.
Hendriks PM, Ho-dac Pannekeet MM, van Gulik TM, Struijk DG, Phoa SS, Sie L, Kox C, Krediet RT: Peritoneal sclerosis in chronic peritoneal dialysis patients: analysis of clinical presentation, risk factors, and peritoneal transport kinetics. Perit Dial Int 1997;17:136–143.
[PubMed]
36.
Kawanishi H, Kawaguchi Y, Fukui H, Hara S, Imada A, Kubo H, Kin M, Nakamoto M, Ohira S, Shoji T: Encapsulating peritoneal sclerosis in Japan: a prospective, controlled, multicenter study. Am J Kidney Dis 2004;44:729–737.
[PubMed]
37.
Mateijsen MA, van der Wal AC, Hendriks PM, Zweers MM, Mulder J, Struijk DG, Krediet RT: Vascular and interstitial changes in the peritoneum of CAPD patients with peritoneal sclerosis. Perit Dial Int 1999;19:517–525.
[PubMed]
38.
Nomoto Y, Kawaguchi Y, Kubo H, Hirano H, Sakai S, Kurokawa K: Sclerosing encapsulating peritonitis in patients undergoing continuous ambulatory peritoneal dialysis: a report of the Japanese Sclerosing Encapsulating Peritonitis Study Group. Am J Kidney Dis 1996;28:420–427.
[PubMed]
39.
Rottembourg J, Gahl GM, Poignet JL, Mertani E, Strippoli P, Langlois P, Tranbaloc P, Legrain M: Severe abdominal complications in patients undergoing continuous ambulatory peritoneal dialysis. Proc Eur Dial Transpalnt Assoc 1983;20:236–242.
[PubMed]
40.
Sampimon DE, Coester AM, Struijk DG, Krediet RT: Time course of peritoneal transport parameters in peritoneal dialysis patients who develop peritoneal sclerosis. Adv Perit Dial 2007;23:107–111.
[PubMed]
41.
Dobbie JW: Pathogenesis of peritoneal fibrosing syndromes (sclerosing peritonitis) in peritoneal dialysis. Perit Dial Int 1992;12:14–27.
[PubMed]
42.
Oulès R, Challah S, Brunner FP: Case-control study to determine the cause of sclerosing peritoneal disease. Nephrol Dial Transplant 1988;3:66–69.
[PubMed]
43.
Bozkurt D, Taskin H, Sezak M, Bicak S, Sen S, Ok E, Duman S: Rosiglitazone, a peroxisome proliferator-activated receptor agonist, improves peritoneal alterations resulting from an encapsulated peritoneal sclerosis model. Adv Perit Dial 2008;24:32–38.
[PubMed]
44.
Duman S, Bozkurt D, Sipahi S, Sezak M, Ozkan S, Ertilav M, Sen S, Ok E: Effects of everolimus as an antiproliferative agent on regression of encapsulating peritoneal sclerosis in a rat model. Adv Perit Dial 2008;24:104–110.
[PubMed]
45.
Khanna A, Plummer M, Bromberek C, Bresnahan B, Hariharan S: Expression of TGF-β and fibrogenic genes in transplant recipients with tacrolimus and cyclosporine nephrotoxicity. Kidney Int 2002;62:2257–2263.
[PubMed]
46.
Van Westrhenen R, Aten J, Hajji N, de Boer OJ, Kunne C, de Waart DR, Krediet RT: Cyclosporin A induces peritoneal fibrosis and angiogenesis during chronic peritoneal exposure to a glucose-based, lactate-buffered dialysis solution in the rat. Blood Purif 2007;25:466–472.
[PubMed]
47.
Zareie M, Keuning ED, Ter Wee PM, Beelen RH, van den Born J: Peritoneal dialysis fluid-induced changes of the peritoneal membrane are reversible after peritoneal rest in rats. Nephrol Dial Transplant 2005;20:189–193.
[PubMed]
48.
Vrtovsnik F, Coester AM, Lopes Barreto D, de Waart DR, van der Wal A, Struijk DG, Krediet RT, Zweers MM: The induction of chronic kidney failure in a long-term peritoneal exposure model in the rat: effects on functional and structural peritoneal alterations. Perit Dial Int 2010 (in press).
49.
Yuan J, Fang W, Ni Z, Dai H, Lin A, Cao L, Qian J: Peritoneal morphologic changes in a peritoneal dialysis rat model correlate with angiopoietin/Tie-2. Pediatr Nephrol 2009;24:163–170.
[PubMed]
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