Sclerosing Encapsulating Peritonitis in Rats: an Experimental Study with Intraperitoneal Antiseptics1

Mackow, Robert C.; Winchester, James F.; Argy, William P.; Andrews, Peter M.; Fields, Phillip A.; Bates, S. A. E.; Rakowski, Thomas A.; Schreiner, George E.

doi:10.1159/000414285

Cited by 26 publications

(15 citation statements)

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“…In regard to intraperitoneal inflammation, EPS may occur not only in severe bacterial or fungal peritonitis, but also with persistent infections such as tuberculous peritonitis (6). Inflammation also results from the intraperitoneal administration of chemical substances and drugs (7,8)—particularly disinfectants (9) and chlorhexidine (10), which readily cause inflammation.…”

Section: Factors Implicated In Eps Developmentmentioning

confidence: 99%

Epidemiology of Encapsulating Peritoneal Sclerosis in Japan

Kawanishi

Moriishi

2005

Perit Dial Int

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Since the first peritoneal dialysis (PD) patients with encapsulating peritoneal sclerosis (EPS) were reported in 1980, EPS has been considered primarily a fatal complication. The incidence of EPS in PD patients has been reported to range from 0.7% to 7.3%, and the rate appears to be higher in patients receiving long-term treatment. The most recent data from Japan show an overall incidence of 2.5%, with a clear impact of extended PD duration, which also augments mortality. The incidence increases and the prognosis worsens with longer durations of PD. The incidences (and mortality rates) for EPS were 0% (0%), 0.7% (0%), 2.1% (8.3%), 5.9% (28.6%), 5.8% (61.5%), and 17.2% (100%) for patients who had undergone PD for 3, 5, 8, 10, 15, and >15 years respectively. Because EPS occurs after withdrawal from PD in more than half of patients with the condition, strict monitoring is necessary when a long-term patient is withdrawn from PD. Maintaining patients on standard PD for more than 8 years using conventional solutions is associated with a substantial risk for the development of EPS.

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Section: Factors Implicated In Eps Developmentmentioning

confidence: 99%

Epidemiology of Encapsulating Peritoneal Sclerosis in Japan

Kawanishi

Moriishi

2005

Perit Dial Int

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“…Experimental studies with rats in vivo (119,122) and with kidney epithelial cells in vitro (123) have revealed that when this disinfectant reaches the peritoneum, striking pathologic changes occur in the mesothelium, submesothelial stroma, and underlying muscle. SP induced in rats by intraperitoneal administration of chlorhexidine (124,125) has been used as an animal model for studying the capacity of drugs, such as pirfenidone (126), to prevent fibrosis.…”

Section: Etiology and Pathogenesismentioning

confidence: 99%

“…Intraperitoneal use of povidone‐iodine by surgeons in patients not on PD (127) has also been associated with SP. The syndrome has been reproduced in rats (125) by chronic intraperitoneal infusion of small doses of the antiseptic.…”

Section: Etiology and Pathogenesismentioning

confidence: 99%

Peritoneal Sclerosis: One or Two Nosological Entities?

Garosi

Paolo

2000

Seminars in Dialysis

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The frequency, pathology, animal models, pathogenesis, clinical manifestations, diagnostic criteria, therapy and prevention of peritoneal sclerosis are reviewed. Many of these aspects have a bimodal configuration which suggests that peritoneal sclerosis, usually considered a single pathology in peritoneal dialysis, is actually two distinct nosological entities: simple sclerosis and sclerosing peritonitis. The former is very frequent, with minor anatomical alterations and low clinical impact; it is reproducible in animals by means of peritoneal dialysis, and is clearly due to the poor biocompatibility of peritoneal dialysis solutions. The latter is rare, with radical anatomical alterations and high mortality requiring valid methods of diagnosis, therapy and prevention; it can only be reproduced in animal models by means other than peritoneal dialysis and seems to be due to factors both related and unrelated to peritoneal dialysis.

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“…It is not exclusive to PD but this review will focus on patients on PD or former PD patients [ 75 ]. For that reason, experimental models have been developed, which induced an EPS-like pattern by means of intraperitoneal application of several agents, for example, acidic glucose solution with pH inferior to 4 [ 76 ], chlorhexidine gluconate [ 77 , 78 ], chlorhexidine acetate, povidone iodine, and also formaldehyde [ 79 ], as well as bleach plus whole blood [ 4 ]. Recently, mouse models have been established, which offer the possibility of investigating peritoneal transformations in the context of genetic alterations with specific regard to molecular mechanisms involved in that process [ 18 ].…”

Section: Encapsulating Peritoneal Sclerosis (Eps)mentioning

confidence: 99%

Animal Models of Peritoneal Dialysis: Thirty Years of Our Own Experience

Pawlaczyk

Baum

Schwermer

et al. 2015

BioMed Research International

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Experimental animal models improve our understanding of technical problems in peritoneal dialysis PD, and such studies contribute to solving crucial clinical problems. We established an acute and chronic PD model in nonuremic and uremic rats. We observed that kinetics of PD in rats change as the animals are aging, and this effect is due not only to an increasing peritoneal surface area, but also to changes in the permeability of the peritoneum. Changes of the peritoneal permeability seen during chronic PD in rats are comparable to results obtained in humans treated with PD. Effluent dialysate can be drained repeatedly to measure concentration of various bioactive molecules and to correlate the results with the peritoneal permeability. Additionally we can study in in vitro conditions properties of the effluent dialysate on cultured peritoneal mesothelial cells or fibroblasts. We can evaluate acute and chronic effect of various additives to the dialysis fluid on function and permeability of the peritoneum. Results from such study are even more relevant to the clinical scenario when experiments are performed in uremic rats. Our experimental animal PD model not only helps to understand the pathophysiology of PD but also can be used for testing biocompatibility of new PD fluids.

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Sclerosing Encapsulating Peritonitis in Rats: an Experimental Study with Intraperitoneal Antiseptics1

Cited by 26 publications

References 0 publications

Epidemiology of Encapsulating Peritoneal Sclerosis in Japan

Epidemiology of Encapsulating Peritoneal Sclerosis in Japan

Peritoneal Sclerosis: One or Two Nosological Entities?

Animal Models of Peritoneal Dialysis: Thirty Years of Our Own Experience

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