HYALURONAN DECREASES PERITONEAL-FLUID ABSORPTION IN PERITONEAL-DIALYSIS

Hyaluronan, exhibiting a high resistance against water flow, acts in t he tissue as a barrier against rapid changes in water content. To test whether hyaluronan has any effect on the peritoneal fluid and solute transport, and, in particular, on the peritoneal fluid absorption, a 4 -h dwell study with an intraperitoneal volume marker (radiolabeled hum an serum albumin [RISA]) was conducted in 21 male Sprague Dawley rats (three groups, seven rats in each group). Each rat was injected intrap eritoneally with 25 mi of 1.36% glucose solution alone (control group) , with 0.005% hyaluronan (HA1 group), or with 0.01% hyaluronan (HA2 gr oup). Dialysate and blood samples were taken frequently for analyses o f fluid and solute (urea, glucose, and protein) transport. The intrape ritoneal volume was calculated from the dilution of RISA with a correc tion for RISA disappearance from the peritoneal cavity. This study sho ws that adding hyaluronan to peritoneal dialysis solution significantl y (P < 0.01) increased the net peritoneal fluid removal, mainly due to a significant decrease in the peritoneal fluid absorption rate (P < 0 .01). The diffusive mass transfer coefficients for glucose, urea, and protein did not differ between the three groups. The peritoneal cleara nce of urea increased significantly in the two hyaluronan groups compa red with the control group, due to the increased net fluid removal in the hyaluronan groups. These results suggest that intraperitoneal admi nistration of hyaluronan during a single peritoneal dialysis exchange may significantly increase the peritoneal fluid and solute removal by decreasing peritoneal fluid absorption.