Deoxycholate Effects on Plasma Solute Clearance by Gut Perfusion in Dog

Abstract

In vivo luminal perfusion of in situ intestinal segments isolated from continuity with the alimentary tract has been used to treat uremia. One prior study showed that 2 mM deoxycholate markedly increased clearances of inorganic phosphorus, urate, urea, and creatinine. The other investigation failed to confirm the increased inorganic phosphorus or urate clearance. Because of the clinical potential of the findings, we systematically examined the effects of perfusing deoxycholate (2, 7, 15, and 30 mM) on clearance of plasma solutes by a 90-cm jejunal Thiry-Vella loop in the conscious dog. During control perfusion, clearance of all solutes was in a steady state in the final five of seven successive 30-min samples. During deoxycholate perfusion, all solutes except inorganic phosphorus and urate also attained a steady state of clearance in these final five samples. Inorganic phosphorus and urate clearances were elevated several orders of magnitude above control, but only during the first two 30-min collection periods. This increase was deoxycholate concentration-dependent and progressively declined during the subsequent five 30-min collection periods (P < 0.0001). Steady-state clearances of sodium, potassium, calcium, chloride, and creatinine were increased (P < 0.05) by 2 mM deoxycholate. Clearance of urea was decreased by deoxycholate. In summary, (a) deoxycholate increased clearances of most solutes, but steady-state increases were modest; (b) clearances tended to increase further with increasing deoxyeholate; (c) the markedly increased clearances in a prior study were probably non-steady state; (d) urea clearance was decreased by deoxycholate. We conclude that detergents such as deoxycholate cause only modest increases in steady-state gastrointestinal clearance of plasma solutes.