Related Experiment Video
Updated: Jul 3, 2026
A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
Published on: July 20, 2022
A positive effect of AII inhibitors on peritoneal membrane function in long-term PD patients
Inna Kolesnyk1, Marlies Noordzij, Friedo W Dekker
1Department of Medicine, Division of Nephrology, Academic Medical Centre, University of Amsterdam , the Netherlands. i.kolesnyk@amc.uva.nl
Background:
Experimental studies showed that inhibition of AII effects attenuates the development of peritoneal membrane fibrosis and neoangiogenesis. The latter leads to an increase of peritoneal solute transport and ultrafiltration failure. The results of a single-centre study showed that use of ACEI/ARB can prevent the increase of small solute transport in long-term PD patients. Our aim was to investigate whether these results would also be present in a larger population and influence patient and technique survival in long-term PD.
Methods:
We analysed data from 217 long-term CAPD patients, participating in the Netherlands Cooperative Study on Adequacy of Dialysis (NECOSAD). Included patients underwent CAPD therapy for at least 2 years; 120 of them were treated with the ACE/AII inhibitors-ACEI/ARB group. The control group consisted of 87 patients who received none of the above drugs and 10 patients who had them for <25% of their time on PD.
Results:
A significant difference in the time course of peritoneal transport was found between the two groups. The value of 24-h D/P creatinine was associated with the PD duration (P = 0.01) and its time course was influenced by use of ACEI/ARB (P = 0.05). We found no effect of ACEI/ARB on patient survival, but some benefit was found for the technique survival: in a multivariate model the hazard ratio for the group with the longest use of ACEI/ARB was 0.5 (CI 0.22-1.4), P = 0.19.
Conclusions:
We conclude that AII inhibition prevents the increase in small solute transport in long-term PD. These drugs may also have some positive influence on PD technique survival.
Related Concept Videos
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:25Peritoneal Dialysis III: Nursing Management
01:30Peritoneal Dialysis I: Introduction and Procedure
01:18Indirect-Acting Cholinergic Agonists: Mechanism of Action
Reversible inhibitors like edrophonium bind to a specific part of the enzyme called the anionic catalytic site. They form noncovalent bonds, which means they are not strongly attached to the enzyme. This creates a temporary and less stable enzyme–inhibitor complex, leading to...
01:24Parkinson's Disease: Treatment
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of its...
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...