Effect of Chlorpromazine on Peritoneal Clearances

Indraprasit, Suchati; Sooksriwongse, Cha-onsin

doi:10.1159/000183489

Cited by 17 publications

(5 citation statements)

References 12 publications

(13 reference statements)

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“…It should be noted that Indraprasit and Sooksriwongest [9] also obtained clearances which were higher than those of controls by using chlorpromazine peritoneally and this increase was attributed to greater liquid trans port (convection).…”

Section: Discussionmentioning

confidence: 90%

“…ysis without modifying the osmotic power of the solution. The first report by Indraprasit and Sooksriwongest [9] cam out in 1985: a study on the kinetics of peritoneally administered chlorpromazine in patients on CAPD which revealed that this drug caused an increase in ultra filtration and in peritoneal clearances. An accurate inves tigation on its pharmacological action had led to the conclusion that the only possibility was that chlorproma zine would act by lowring superficial tension, hence its effect on peritoneal transport.…”

Section: Discussionmentioning

confidence: 99%

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Phosphatidylcholine and Peritoneal Transport during Peritoneal Dialysis

Paolo¹,

Buoncristiani²,

Capotondo³

et al. 1986

Nephron

102

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Peritoneal effluent of patients on chronic ambulatory peritoneal dialysis (CAPD) contains a surface-active material (SAM) made up of phospholipids and showing phosphatidylcholine on thin-layer chromatography. This substance drastically lowers surface tension, helps to repel water and has a lubricating effect. The presence of stratified phosphatidylcholine on the peritoneum might narrow the stagnant dialysate fluid layer and situations which can alter the quantity or composition of SAM may affect peritoneal transport and also, perhaps, the formation of adherences. This led us to verify, experimentally, the presence of phospholipids in basal conditions, after CAPD and during peritonitis and to check if addition of phosphatidylcholine to dialysis liquid is able to modify water transport in patients with low ultrafiltration and peritonitis. Phospholipids in the dialysis effluent of patients who have been on CAPD for a long time are lower than observed in the first days of peritoneal dialysis. A more drastic, significant decrease in phospholipids was observed in patients with low ultrafiltration and in patients with peritonitis. Mean ultrafiltration significantly increases in patients with low ultrafiltration and in those with peritonitis during dialysis exchanges containing phosphatidylcholine (50 mg/) indicating that the latter is able to restore normal physiological conditions.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Phosphatidylcholine and Peritoneal Transport during Peritoneal Dialysis

Paolo¹,

Buoncristiani²,

Capotondo³

et al. 1986

Nephron

102

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“…Phosphatidylcholine [14] and chlorpromazine [15] have also been shown to increase measured ultrafiltra tion and solute clearances without increasing the osmotic pressure of the dialysis solution or changing peritoneal permeability times area. With these drugs it was con cluded that the increase in dialysate drain volumes re sulted from a reduction in surface tension, a decrease in the thickness of the stagnant fluid film over the mésothél ium and consequently an increase in water and solute transperitoneal transport.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological Reduction of Lymphatic Absorption from the Peritoneal Cavity Increases Net Ultrafiltration and Solute Clearances in Peritoneal Dialysis

Mactier

Khanna

Moore

et al. 1988

Nephron

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Lymphatic drainage from the peritoneal cavity occurs mainly via the subdiaphragmatic stomata and significantly reduces net ultrafiltration and solute clearances during long-dwell peritoneal dialysis. Intraperitoneal cholinergic drugs constrict these stomata and may reduce peritoneal cavity lymphatic absorption. We evaluated ultrafiltration kinetics, solute transport, and lymphatic drainage during single hypertonic exchanges in rats using 2.5% dextrose dialysis solution with and without added neostigmine. Net ultrafiltration was enhanced in the neostigmine group (p < 0.01) by a reduction in cumulative lymphatic absorption (p < 0.01) and without an increase in total transcapillary ultrafiltration during the dwell time. Likewise solute clearances were significantly augmented with neostigmine primarily due to the increase in dialysate drain volume (p < 0.01) since dialysate/serum solute ratios were unchanged. Pharmacological manipulation of peritoneal lymphatic absorption provides an alternative means of increasing the efficiency of long-dwell peritoneal dialysis without altering peritoneal transport of solutes and water.

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“…P reservation of ultrafiltration (UF) volume is a major concern in maintaining long-term continuous ambulatory peritoneal dialysis (CAPD), since loss of UF volume is the main reason for patient dropout. Several pharmacological agents have proven to be effective in enhancing solute transport and water transport (1)(2)(3)(4)(5)(6)(7)(8)(9). However, they have not been used in clinical practice because their clinical usefulness has not yet been established.…”

Section: ♦ ♦ ♦ ♦ ♦ Conclusionmentioning

confidence: 99%

Tranexamic Acid Increases Peritoneal Ultrafiltration Volume in Patients on Capd

et al. 1999

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Objective The preservation of ultrafiltration (UF) capacity is crucial to maintaining long-term continuous ambulatory peritoneal dialysis (CAPD). The aim of the present study was to investigate whether the antiplasmin agent tranexamic acid (TNA) increases UF volume in CAPD patients. Patients and Methods Fifteen patients on CAPD, 5 with UF loss and 10 without UF loss, were recruited for the study. The effect of TNA was evaluated with respect to changes in UF volume, peritoneal permeability, peritoneal clearance, bradykinin (BK), and tissue plasminogen activator (tPA) concentration. Setting Dialysis unit of the Saiseikai Central Hospital. Results In patients with UF loss, 2 weeks of treatment with oral TNA produced a significant increase in UF volume in all subjects (5/5). TNA also produced a significant increase in peritoneal clearances of urea and creatinine (Cr). However, the peritoneal equilibration test (PET) revealed that TNA had no effect on dialysate/plasma (D/P) Cr, Kt/V, or the protein catabolic rate (PCR). TNA also had no effect on net glucose reabsorption. In contrast, significant decreases in BK and blood tPA concentrations in response to TNA treatment were noted. BK concentration in drainage fluid was also reduced. In the case of patients without UF loss, TNA produced an increase in UF volume in 70% (7/10). However, no differences were found in blood and drainage BK and tPA concentrations between the TNA treatment and nontreatment periods in these patients. A comparison of basal BK and tPA concentration showed that there were no differences in these parameters between patients with UF loss and those without loss of UF. Furthermore, TNA given intraperitoneally to a patient also produced a marked increase in UF volume. Conclusion The present study suggests that TNA enhances UF volume in patients both with and without UF loss. Since TNA did not affect peritoneal permeability and glucose reabsorption, the mechanism by which TNA exerts an enhancing action on UF is largely unknown. We speculate that it may be associated with suppression of the BK and/or tPA system, at least in patients with UF loss.

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Effect of Chlorpromazine on Peritoneal Clearances

Cited by 17 publications

References 12 publications

Phosphatidylcholine and Peritoneal Transport during Peritoneal Dialysis

Phosphatidylcholine and Peritoneal Transport during Peritoneal Dialysis

Pharmacological Reduction of Lymphatic Absorption from the Peritoneal Cavity Increases Net Ultrafiltration and Solute Clearances in Peritoneal Dialysis

Tranexamic Acid Increases Peritoneal Ultrafiltration Volume in Patients on Capd

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