Abstract

Long-term peritoneal dialysis (PD) is associated with the development of functional and structural alterations of the peritoneal membrane. The present study reports the effects of chronic exposure to PD fluid on mesenteric leukocyte-endothelium interactions, using intravital video microscopy. Rats (n = 7) received 10 mL lactate-buffered 3.86% glucose-containing PD fluid daily during a 5-week period via a subcutaneously implanted mini access port that was connected via a catheter to the peritoneal cavity. In a first control group (n = 8), catheters were implanted but no fluid was instilled; a second control group (n = 8) remained untreated. The number of rolling and adherent leukocytes as well as blood flow and other fluid dynamic variables were analyzed in mesenteric postcapillary (diameter 10-25 mu) and collecting (diameter 26-40 mu) venules. Neovascularization was semiquantitatively assessed after inspection of video images and by light and electron microscopy. Using FITC-labeled albumin, microvascular leakage was examined. Rats exposed to PD fluid showed a more than twofold increase in the number of rolling leukocytes (p < 0.01); the number of adherent leukocytes was not changed. Furthermore, exposure to PD fluid induced severe neovascularization in rat mesentery. No microvascular leakage was observed in the various groups. The observed differences could not be explained by differences in systemic or local hemodynamic parameters or peripheral leukocyte counts, but is most likely associated with new vessel formation. Exposure of rat peritoneal membrane to conventional PD fluid for 5 weeks affected local leukocyte-endothelium interactions. In addition, severe angiogenesis was induced, whereas microvascular permeability remained unaltered.

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