Koçak Gülay, Azak Alper, Astarcı Hesna Müzeyyen, Huddam Bülent, Karaca Gökhan, Ceri Mevlüt, Can Murat, Sert Mehmet, Duranay Murat
Department of Nephrology Pathology General Surgery, Ankara Education and Research Hospital, Ankara, Turkey.
Ther Apher Dial. 2012 Feb;16(1):75-80. doi: 10.1111/j.1744-9987.2011.01031.x.
Sclerosing encapsulated peritonitis (SEP) is a rare complication of long term peritoneal dialysis. Renin-angiotensin-aldosterone system (RAAS) may play a role in the development of peritoneal fibrosis in CAPD patients. We aimed to evaluate the effect of aliskiren, valsartan, and aliskiren + valsartan therapy on SEP. The study included 30 Wistar albino rats which were divided into five groups: I (Control) SF solution i.p.; II (CG group) chlorhexidine gluconate i.p.; III aliskiren oral plus CG i.p.; IV valsartan oral plus CG i.p.; and V aliskiren oral, valsartan oral and CG i.p. On the twenty-first day, all of the rats were sacrificed. All of the groups were analyzed in terms of peritoneal thickness, degree of inflammation, vasculopathy, neovascularization and fibrosis. Also, the parietal peritoneal tissue samples were evaluated for matrix metalloproteinase 2 (MMP-2) using the ELISA method. Peritoneal thickness and fibrosis scores were lower in the valsartan group compared to the CG group (P < 0.05). Peritoneal fibrosis scores were lower in the aliskiren group compared to CG group (P < 0.05) but no difference was observed between the peritoneal thickness scores of the two groups (P > 0.05). Tissue MMP-2 levels were significantly higher in the CG group compared other groups (P < 0.05). There were no statistically significant differences between the aliskiren, valsartan and aliskiren + valsartan groups according to the tissue MMP-2 levels. Due to the antifibrotic properties of valsartan, it is thought to be a possible choice to prevent SEP development. We found no positive impact of aliskiren or aliskiren + valsartan combination compared to valsartan alone.
硬化性包裹性腹膜炎（SEP）是长期腹膜透析的一种罕见并发症。肾素-血管紧张素-醛固酮系统（RAAS）可能在持续性非卧床腹膜透析（CAPD）患者腹膜纤维化的发展中起作用。我们旨在评估阿利吉仑、缬沙坦以及阿利吉仑+缬沙坦联合治疗对SEP的影响。该研究纳入了30只Wistar白化大鼠，将其分为五组：I组（对照组）腹腔注射SF溶液；II组（CG组）腹腔注射葡萄糖酸氯己定；III组口服阿利吉仑并腹腔注射CG；IV组口服缬沙坦并腹腔注射CG；V组口服阿利吉仑、口服缬沙坦并腹腔注射CG。在第21天，处死所有大鼠。对所有组的腹膜厚度、炎症程度、血管病变、新生血管形成和纤维化情况进行分析。此外，采用酶联免疫吸附测定（ELISA）法评估壁层腹膜组织样本中的基质金属蛋白酶2（MMP-2）。与CG组相比，缬沙坦组的腹膜厚度和纤维化评分更低（P<0.05）。与CG组相比，阿利吉仑组的腹膜纤维化评分更低（P<0.05），但两组的腹膜厚度评分之间未观察到差异（P>0.05）。与其他组相比，CG组的组织MMP-2水平显著更高（P<0.05）。根据组织MMP-2水平，阿利吉仑组、缬沙坦组和阿利吉仑+缬沙坦联合组之间无统计学显著差异。由于缬沙坦的抗纤维化特性，它被认为是预防SEP发展的一种可能选择。我们发现，与单独使用缬沙坦相比，阿利吉仑或阿利吉仑+缬沙坦联合用药没有积极作用。
