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Low molecular weight heparin improves peritoneal ultrafiltration and blocks complement and coagulation
Farhan Bazargani1, Ann Albrektsson, Noushin Yahyapour
1Department of Anatomy and Cell Biology, University of Göteborg, Göteborg, Sweden.
Summary
Low molecular weight heparin (LMWH) improved ultrafiltration in peritoneal dialysis (PD) by inhibiting complement and coagulation activation. This study shows LMWH reduces inflammation and enhances fluid removal during PD dwells.
Area of Science:
- Peritoneal dialysis research
- Inflammation and immunology
- Renal medicine
Background:
- Peritoneal dialysis (PD) patients exhibit activation of intraperitoneal (IP) complement and coagulation systems.
- Low molecular weight heparin (LMWH) has shown potential in inhibiting peritoneal angiogenesis and improving ultrafiltration in PD patients.
Purpose of the Study:
- To evaluate the effects of LMWH on ultrafiltration, coagulation, and complement activation during a single PD dwell.
- To investigate the role of IP cascade systems in the acute inflammatory response to PD fluid.
Main Methods:
- Rats received a single dose of PD fluid with or without LMWH via IP injection or catheter infusion.
- Analysis of dwell fluid included complement and coagulation cascade activation, chemotactic activity, neutrophil recruitment, and ultrafiltration volume.
Main Results:
- PD fluid induced IP complement and coagulation activation, and neutrophil recruitment.
- LMWH inhibited neutrophil recruitment and complement activation in IP injection models.
- LMWH reduced thrombin formation, decreased chemotactic activity, and improved ultrafiltration in both models.
Conclusions:
- The acute inflammatory response in PD fluid involves complement and coagulation cascades.
- LMWH addition to PD fluid enhances ultrafiltration and inhibits thrombin formation.
- Further research into IP cascade systems in PD is warranted based on these findings.