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Amphotericin B does not increase peritoneal fluid removal.

T Wang1, O Heimbürger, H H Cheng

  • 1Division of Baxter Novum, Huddinge University Hospital, Karolinska Institute, Sweden.

Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis
|January 29, 2000
PubMed
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Intraperitoneal amphotericin B (AmB) did not increase peritoneal fluid removal in rats after a 4-hour dwell. However, AmB administration led to higher potassium levels, suggesting a potential cytotoxic effect.

Area of Science:

  • Nephrology
  • Pharmacology
  • Peritoneal Dialysis

Background:

  • Intraperitoneal amphotericin B (AmB) has been linked to increased ultrafiltration in rabbits.
  • The effect of AmB on peritoneal fluid kinetics in rats remains to be fully elucidated.

Purpose of the Study:

  • To investigate the impact of intraperitoneal amphotericin B on peritoneal fluid kinetics in a rat model.
  • To determine if AmB influences fluid absorption, solute transport, and potassium levels during peritoneal dialysis.

Main Methods:

  • Rats underwent a 4-hour peritoneal dwell with dialysis solution containing either no AmB (control), low-dose AmB (L-AmB), or high-dose AmB (H-AmB).
  • Intraperitoneal volume was tracked using 131I-albumin, with frequent sampling of dialysate and blood.
  • Solute transport (glucose, urea, sodium, potassium, total protein) was assessed by measuring dialysis-to-plasma concentration ratios (D/P) and diffusive mass transport coefficients (KBD).

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Main Results:

  • No significant differences in total fluid drainage volume were observed between groups after 4 hours.
  • Higher intraperitoneal volumes were noted in the H-AmB group at earlier time points (60-120 minutes).
  • Potassium D/P and KBD values, along with potassium clearances, were significantly higher in both AmB groups compared to the control.

Conclusions:

  • Intraperitoneal AmB does not enhance peritoneal fluid removal after a 4-hour dwell in rats.
  • While membrane permeability appears unaffected, elevated potassium levels suggest a localized cytotoxic effect of AmB.
  • The potential contribution of cellular water release to increased intraperitoneal volume in the H-AmB group cannot be excluded.