The breakdown of preformed peritoneal advanced glycation end products by intraperitoneal alagebrium.

It has been demonstrated that inhibitors of advanced glycation end products (AGE), such as aminoguanidine, can suppress peritoneal AGE in rats on peritoneal dialysis (PD). However, it is unknown whether late administration of a putative cross-link breaker, alagebrium, could reverse peritoneal AGE. We therefore compared alagebrium with aminoguanidine in their ability to reverse peritoneal AGE in rats on PD. Male Sprague-Dawley rats were randomly divided into 3 groups: group I dialyzed with 4.25% glucose solution for all exchanges; group II dialyzed with 4.25% glucose solution containing aminoguanidine, and group III dialyzed with 4.25% glucose solution containing alagebrium for last 8 weeks of 12-week dialysis period. Dialysis exchanges were performed 2 times a day for 12 weeks. Immunohistochemistry was performed using a monoclonal anti-AGE antibody. One-hour PET was performed for comparison of transport characteristics. The immunolabelling of AGE in peritoneal membrane was markedly decreased in the alagebrium group. Consistent with this, the alagebrium group exhibited significantly higher D/Do glucose and lower D/P urea, suggesting low peritoneal membrane transport. But there were no significant differences between the control and the aminoguanidine group. These results suggest that the alagebrium may be the optimal therapeutic approach, compared with treatment with inhibitors of AGE formation, in rats on PD.

Relapsing peritonitis caused by Bordetella bronchiseptica in continuous ambulatory peritoneal dialysis patient: a case report.

Bordetella (B) bronchiseptica is a common veterinary pathogen, but has rarely been implicated in human infections. Most patients with B. bronchiseptica infections are compromised clinically such as in patients with a malignancy, AIDS, malnutrition, or chronic renal failure. We experienced a case of relapsing peritonitis caused by B. bronchiseptica associated with continuous ambulatory peritoneal dialysis (CAPD). A 56-yr-old male, treated with CAPD due to end stage renal disease (ESRD), was admitted with complaints of abdominal pain and a turbid peritoneal dialysate. The culture of peritoneal dialysate identified B. bronchiseptica. The patient was treated with a combination of intraperitoneal antibiotics. There were two further episodes of relapsing peritonitis, although the organism was sensitive to the used antibiotics. Finally, the indwelling CAPD catheter was removed and the patient was started on hemodialysis. This is the first report of a B. bronchiseptica human infection in the Korean literature.

Using reagent strips for rapid diagnosis of peritonitis in peritoneal dialysis patients.

Rapid diagnosis of peritonitis remains a significant goal in the management of patients who are maintained on peritoneal dialysis (PD). Several attempts to use leukocyte esterase reagent strips to diagnose peritonitis have been described. In the present study, we evaluated the usefulness of a new reagent strip, the PeriScreen Test Strip (Serim Research, Elkhart, IN, U.S.A.), for diagnosis of peritonitis in PD patients. This reagent strip for leukocyte esterase was designed to test PD fluid. It has 4 colorimetric grades (negative, trace, small, and large). We used the strips to evaluate PD fluid in 54 PD patients. In those patients, we diagnosed 19 episodes of peritonitis as defined by the criteria set out by the International Society for Peritoneal Dialysis. The test strips showed a sensitivity of 100%, a specificity of 97%, a positive predictive value of 95%, and a negative predictive value of 100%. PeriScreen Test Strip reagent strips have excellent utility as a simple, rapid bedside screening test to exclude peritonitis in PD patients.