Douma C E, de Waart D R, Zemel D, Imholz A L, Koomen G C, Struijk D G, Krediet R T
Department of Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Adv Perit Dial. 1995;11:36-40.
During continuous ambulatory peritoneal dialysis (CAPD) peritoneal vessels are dilated. Nitric oxide (NO) causes vasodilation in many organs. Nitrate, a stable metabolite of NO, was measured in plasma and dialysate. In 6 stable CAPD patients standard peritoneal analyses were performed. The mass transfer area coefficient (MTAC) of nitrate was 11.5 mL/min (10.0-17.0 mL/min) (median and range). The MTAC of creatinine was of the same order of magnitude: 10.7 mL/min (8.0-14.2 mL/min), although the molecular weight of nitrate is lower (62 vs 113 dalton). The correlation between the MTAC of nitrate and the MTAC of creatinine indicated diffusion from the circulation and not local production of NO (r = 0.71; p = 0.11). Peritoneal permeability is increased in the acute phase of peritonitis, partly caused by extensive vasodilation. The potential role of NO during peritonitis was investigated in 8 CAPD patients with 11 peritonitis episodes in the acute phase and after recovery. The median dialysate/plasma (D/P) ratio of nitrate in the acute phase was 1.47 (range 0.96-2.55), which was higher than after recovery: 1.07 (0.99-1.75), p < 0.05. No relation was found between the D/P ratio of nitrate and the D/P ratio of TNF alpha (tumor necrosis factor). In conclusion, dialysate nitrate levels in stable CAPD patients are likely to be determined by diffusion from the circulation. D/P ratios exceeding 1.0 during the acute phase of peritonitis are probably the result of local NO production. This may contribute to the marked vasodilation during peritonitis.
在持续性非卧床腹膜透析（CAPD）过程中，腹膜血管会扩张。一氧化氮（NO）可使许多器官血管舒张。NO的稳定代谢产物硝酸盐在血浆和透析液中进行了测定。对6例稳定的CAPD患者进行了标准的腹膜分析。硝酸盐的传质面积系数（MTAC）为11.5 mL/min（10.0 - 17.0 mL/min）（中位数和范围）。肌酐的MTAC处于相同数量级：10.7 mL/min（8.0 - 14.2 mL/min），尽管硝酸盐的分子量较低（62对113道尔顿）。硝酸盐MTAC与肌酐MTAC之间的相关性表明其来自循环系统的扩散而非局部NO生成（r = 0.71；p = 0.11）。在腹膜炎急性期，腹膜通透性增加，部分原因是广泛的血管舒张。对8例CAPD患者在急性期和恢复后的11次腹膜炎发作期间NO的潜在作用进行了研究。急性期透析液/血浆（D/P）硝酸盐比值中位数为1.47（范围0.96 - 2.55），高于恢复后：1.07（0.99 - 1.75），p < 0.05。未发现硝酸盐D/P比值与肿瘤坏死因子（TNFα）D/P比值之间存在关联。总之，稳定的CAPD患者透析液中硝酸盐水平可能由循环系统扩散决定。腹膜炎急性期D/P比值超过1.0可能是局部NO生成的结果。这可能导致腹膜炎期间明显的血管舒张。
