N-ACETYLGLUCOSAMINE CHANGES PERMEABILITY OF PERITONEUM DURING CHRONICPERITONEAL-DIALYSIS IN RATS

Objective: To evaluate the effect of supplementation of dialysis fluid with N-acetylglucosamine (NAG) on the permeability of peritoneum duri ng chronic peritoneal dialysis in rats. Design: Experiments were perfo rmed on rats with surgically implanted peritoneal catheters. Dialysis solution [Dianeal 1.5% (Baxter, Deerfield, IL, U.S.A.) supplemented wi th either NAG 50 mmol/L or glucose 50 mmol/L (control)] was infused in traperitoneally twice, every day, for 8 weeks. Peritoneal equilibratio n tests (PET) were performed in all animals at the beginning of the st udy and after 8 weeks of dialysis. Additionally, at the end of each we ek, dialysis solution infused in the morning was drained after 4 hours of intraperitoneal dwell. White blood cell count, creatinine, and tot al protein concentrations were measured in the effluent dialysate. Aft er 8 weeks of dialysis, the morphology of the peritoneum was studied. Results: In rats exposed to dialysis fluid supplemented with NAG, peri toneal permeability to creatinine and proteins was reduced when compar ed to animals dialyzed with glucose solution. In NAG treated animals, staining with alcian blue for polyanions in the peritoneal interstitiu m was significantly stronger than in rats dialyzed with glucose soluti on. Conclusions: Chronic peritoneal dialysis with dialysis solution su pplemented with N-acetylglucosamine causes accumulation of glycosamino glycans in the peritoneal interstitium, which results in a change of p eritoneal permeability.