[Effect of macrophage nitric oxide on the ultrafiltration failure of long-term peritoneal dialysis]

The regulation of macrophage nitric oxide on peritoneal lymphatic stomata was studied for revealing the mechanism of ultrafiltration failure during long-term peritoneal dialysis.

(1) The model of peritoneal dialysis was created by using peritoneal dialysate; (2) Dynamic measurements of nitric oxide (NO) were made during peritoneal dialysis and its cessation; (3) The pathological change of the peritoneal mesothelium in different dialysis time was observed by scanning electron microscope (SEM); (4) Dynamic changes of the peritoneal lymphatic stomata were studied during this experiment by using a computer image processing system attached to SEM.

Numerous macrophages went into the peritoneal cavity through the lymphatic stomata to form a lot of milky spots during peritoneal dialysis. A great quantity of NO produced by macrophages damaging mesothelial cells and increasing numbers and density of lymphatic stomata. After 40 days of peritoneal dialysis, the diameters of the lymphatic stomata were significantly increased in Bieffe group (P < 0.05). During cessation of peritoneal dialysis, few macrophage milky spots were observed and NO quantity was gradually decreased. Then the mesothelium damage began to repair and the peritoneal lymphatic stomata tended to become normal.

Our data demonstrate that a great quantity of NO produced by macrophages would damage peritoneal mesothelium and relax lymphatic stomata which enhance lymphatic reabsorption from the peritoneal cavity so as to make ultrafiltration failure on long-term peritoneal dialysis.