Hyaluronan reduces colitis-induced intraperitoneal inflammation during peritoneal dialysis.

Abstract

Background: Peritoneal dialysis induces the inflammatory response within the peritoneal cavity, which contributes to the progressive damage of the peritoneum. Due to close contact of the peritoneal cavity and the intestines, there is the possibility that the visceral disorders can affect the intraperitoneal inflammation during peritoneal dialysis.

Objectives: Study of the effect of acute colitis on the intraperitoneal inflammation in conditions of peritoneal dialysis and evaluation of the protective effect of hyaluronan in that scenario.

Methods: In rats with the dextran sulphate-induced colitis, 6-h peritoneal dialysis was performed with dianeal 2.5% +/- hyaluronan 10 mg/dL. In the control group, rats without colitis were studied. Peritoneal permeability and dialysate inflammation were studied at the end of the dialysate exchange.

Results: In rats with colitis, intraperitoneal inflammatory reaction was increased as compared with the control group and reflected by the following studied parameters: dialysate cell count (+26%, p < 0.01), number of neutrophils (+75%, p < 0.01), generation of free radicals in the leukocytes (+70%, p < 0.05), dialysate level of elastase (+102%, p < 0.01), tumor necrosis factor α (+48%, p < 0.01) and monocyte chemoattractant protein-1 (+42%, p < 0.01). Drained dialysate volume was lower (-21%, p < 0.01) and peritoneal permeability increased in rats with colitis (+55%, p < 0.01). In animals with the hyaluronan supplemented dialysis fluids, the intensity of the intraperitoneal inflammation was reduced.

Conclusions: Visceral inflammation during colitis induces the inflammatory reaction within the peritoneal cavity that may accelerate damage to the peritoneum. Supplementation of the dialysis fluid with hyaluronan reduces the intensity of that effect.