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Vasodilatation by intraperitoneal addition of nitroprusside is not a model for high peritoneal transport
T Wang1, H H Cheng, O Heimbürger
1Division of Baxter Novum, Karolinska Institute, Huddinge University Hospital, Sweden.
Abstract:
It has been suggested that the peritoneal capillary is the major determinant for peritoneal fluid transport and that an increase in the number of peritoneal capillaries may be the reason for an increased peritoneal transport rate. In this study, we investigated the impact on peritoneal fluid and solute transport of vasodilatation (which may increase the number of perfused capillaries) by intraperitoneal addition of nitroprusside. A 4-hour dwell was performed in four groups of Sprague-Dawley rats (4-8 rats in each group) with 131I albumin as an intraperitoneal volume marker. Nitroprusside at concentrations of 0% (control), 0.0005%, 0.001%, and 0.002% was added to the 3.86% glucose solution before intraperitoneal infusion. Net ultrafiltration (NUF) was 13.2 +/- 0.6 mL, 14.5 +/- 0.7 mL, 13.4 +/- 0.9 mL, and 6.3 +/- 2.0 mL for the control group and the 0.0005%, 0.001%, and 0.002% nitroprusside groups, respectively. No significant differences in peritoneal fluid absorption rate (KE) were observed among the four groups. The intraperitoneal volume, transcapillary ultrafiltration rate (Qu), and peritoneal small-solute transport rate (glucose and urea) as assessed by diffusive mass transfer coefficient were significantly higher or tended to be higher in the 0.0005% nitroprusside group as compared to control. However, with further increase in the dose of nitroprusside, these parameters started to decrease as compared to the 0.0005% nitroprusside group, and NUF was significantly lower in the 0.002% nitroprusside group, conceivably suggesting a reduction in blood flow owing to the systemic effects of nitroprusside. Our study showed that: (1) a low dose of nitroprusside increased the peritoneal small-solute transport rate, but did not decrease peritoneal transcapillary ultrafiltration rate; (2) although a high dose of nitroprusside decreased peritoneal fluid removal, the decrease was not due to an increased small-solute transport rate, but more likely to a significant drop in peritoneal blood flow; (3) vasodilatation by nitroprusside did not change peritoneal fluid absorption rate. Overall, vasodilatation does not seem to produce a pattern of peritoneal fluid kinetics similar to that seen in high transporters, who have a higher peritoneal transport rate, lower transcapillary ultrafiltration rate, and higher peritoneal fluid absorption rate.