Zweers M M, Douma C E, de Waart D R, van der Wardt A B, Ho-dac-Pannekeet M M, Krediet R T, Struijk D G
Department of Nephrology, Academic Medical Center Amsterdam, The Netherlands.
Perit Dial Int. 1999 Jan-Feb;19(1):56-64.
The development of an experimental peritoneal dialysis (PD) model in rabbits to investigate peritoneal transport characteristics during a longitudinal follow-up and to assess normal values of these peritoneal transport parameters.
Peritoneal transport parameters were determined in conscious, unrestrained rabbits by standard peritoneal permeability analysis adjusted for rabbits (SPAR). In this test a 1-hour dwell with 3.86% glucose dialysate is used. Dextran 70 (1g/L) was added to the dialysate to allow calculation of fluid kinetics. Dialysate samples were taken before, 10, and 40 minutes after instillation and at the end of the dwell. Blood was drawn at the end of the dwell.
Eighteen female New Zealand White rabbits (2565 g) were included for catheter implantation. SPARs were performed in 15 animals; the other 3 were excluded due to complications.
The mass transfer area coefficients (MTACs) of the low molecular weight solutes urea (MTAC(urea)) and creatinine (MTACcr) were calculated. The clearances of albumin (CIalb) and IgG (CI(IgG)), glucose absorption, and fluid transport were computed. Coefficients of intraindividual variation (Vc) were calculated for these parameters.
The main complications were catheter obstruction and/or dislocation. Five rabbits underwent uncomplicated PD during a 4-week period. Fifteen SPARs in 15 stable rabbits were performed and analyzed to obtain normal values. Means and standard deviations of the transport parameters were as follows: MTAC(urea) 2.24+/-0.57 mL/min, MTACcr 1.61+/-0.30 mU/min, CI(alb) 52.9+/-17.2 microL/min, CI(IgG) 44.5+/-22.9 UL/min. The transcapillary ultrafiltration rate was 0.66+/-0.13 mL/min and the lymphatic absorption rate 0.47+/-0.26 mL/min. The parameters of solute transport were upscaled to those in humans using two different methods. MTACs of low molecular weight solutes in rabbits and patients were of the same order of magnitude, but the clearance of albumin was approximately four times higher in rabbits than in patients, and that of IgG eight times. In all rabbits sieving of sodium was observed. The dialysate/plasma (D/P) of sodium decreased to a minimum at 40 min (p<0.003 vs the initial value), followed by a rise to 60 min. The minimal value was 0.884+/-0.002. The coefficients of variation calculated on 7 rabbits that underwent two or more SPARs were similar to those assessed from the patient data. This indicates stability of the model and reproducibility of the SPAR.
The conscious rabbit model for PD can be used for repeated studies on peritoneal transport.
建立兔实验性腹膜透析（PD）模型，以纵向随访研究腹膜转运特性，并评估这些腹膜转运参数的正常值。
通过针对兔调整的标准腹膜通透性分析（SPAR），在清醒、不受约束的兔中测定腹膜转运参数。在该试验中，使用含3.86%葡萄糖的透析液进行1小时留腹。向透析液中加入右旋糖酐70（1g/L）以计算液体动力学。在灌注前、灌注后10分钟和40分钟以及留腹结束时采集透析液样本。在留腹结束时采集血液样本。
18只雌性新西兰白兔（2565克）纳入导管植入实验。15只动物进行了SPAR；另外3只因并发症被排除。
计算低分子量溶质尿素（MTAC(尿素)）和肌酐（MTACcr）的质量转运面积系数。计算白蛋白清除率（CIalb）和IgG清除率（CI(IgG)）、葡萄糖吸收和液体转运。计算这些参数的个体内变异系数（Vc）。
主要并发症为导管阻塞和/或移位。5只兔在4周内进行了无并发症的PD。对15只稳定兔进行了15次SPAR并进行分析以获得正常值。转运参数的均值和标准差如下：MTAC(尿素) 2.24±0.57 mL/min，MTACcr 1.61±0.30 mU/min，CI(alb) 52.9±17.2 μL/min，CI(IgG) 44.5±22.9 UL/min。跨毛细血管超滤率为0.66±0.13 mL/min，淋巴吸收率为0.47±0.26 mL/min。使用两种不同方法将溶质转运参数换算为人类参数。兔和患者中低分子量溶质的MTAC处于同一数量级，但兔中白蛋白清除率约为患者的四倍，IgG清除率为患者的八倍。在所有兔中均观察到钠的筛过现象。钠的透析液/血浆（D/P）在40分钟时降至最低（与初始值相比，p<0.003），随后在60分钟时上升。最低值为0.884±0.002。对7只进行了两次或更多次SPAR的兔计算的变异系数与从患者数据评估的结果相似。这表明该模型的稳定性和SPAR的可重复性。
清醒兔PD模型可用于腹膜转运的重复研究。
