Abstract
Background
Bacterial peritonitis episodes may disturb the functional and histological integrity of the peritoneum in peritoneal dialysis patients. The renin–angiotensin–aldosterone system may have fibrotic effects on the peritoneum.
Objective
To study the effects of an angiotensin II receptor antagonist (irbesartan) and an aldosterone antagonist (spironolactone) in the prevention of peritoneal fibrosis in a rat model of bacterial peritonitis.
Methods
40 Wistar rats were randomized into 5 groups: bacteria (B), bacteria–irbesartan (BI), bacteria–spironolactone (BS), bacteria–irbesartan–spironolactone (BIS), and control (C) groups. The C group received only dextran beads (Cytodex; Sigma Chemicals, St Louis, Missouri, USA); the others were given bacteria and dextran beads intraperitoneally. Irbesartan and/or spironolactone were given to 3 groups: BI, BS, and BIS. On the eighth day, the rats were sacrificed, peritoneal adhesion was quantified, and peritoneal tissue sections were evaluated histologically.
Results
The peritoneal total adhesion score was significantly higher in the B group than in the BI, BIS, and C groups (p < 0.01). Mean peritoneal thickness, mean inflammation score, and mean fibrosis score were significantly higher in the B group in comparison to the C group (p < 0.05). Mean peritoneal thickness of all treatment groups was significantly lower than the B group (p < 0.05). Serum transforming growth factor beta-1 level was significantly higher in the B group than in the BI, BS, and C groups (p < 0.05).
Conclusion
Irbesartan and spironolactone seem to decrease the extent of peritoneal injury caused by bacterial peritonitis.
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