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Influence of intraperitoneal vancomycin on peritoneal dialysis efficiency. A clinical study
International Urology and Nephrology
|January 1, 1997
Summary
Vancomycin, an antibiotic for peritonitis in intermittent peritoneal dialysis (IPD), may reduce dialysis efficiency by decreasing peritoneal membrane permeability for small molecules like urea and creatinine.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Peritonitis is a significant complication of intermittent peritoneal dialysis (IPD), with Gram-positive bacteria causing over 70% of infections.
- Vancomycin (V) is the primary antibiotic for treating Gram-positive peritonitis in IPD patients.
Purpose of the Study:
- To investigate the impact of intraperitoneal vancomycin on peritoneal transport and dialysis efficiency in IPD patients.
- To assess vancomycin's effect on parameters such as ultrafiltration, solute transport, and clearances.
Main Methods:
- Eight IPD patients undergoing vancomycin treatment were studied.
- Dialysis solutions with lactate or acetate were used.
- Key parameters measured included net ultrafiltration (UF), solute concentration ratios (D/P) for urea, creatinine, and potassium, peritoneal clearances, mass transfer of sodium (MTNa), and sodium sieving index (SCNa).
Main Results:
- Vancomycin significantly decreased the D/P ratios for urea and creatinine (p < 0.05).
- Mean clearances of urea and creatinine were significantly reduced (p < 0.05).
- No significant changes were observed in UF, MTNa, SCNa, or potassium clearance.
Conclusions:
- Intraperitoneal vancomycin may decrease peritoneal membrane permeability to small solutes in IPD patients.
- This effect could potentially have a negative impact on overall dialysis efficiency.
- Further research is needed to fully understand the implications of vancomycin on peritoneal transport.