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B Rippe

Publications and source records attributed to B Rippe.

121 records · Page 7Linked to original sources

Capillary permeability to albumin in normotensive and spontaneously hypertensive rats.

Transcapillary passage of plasma proteins is enhanced in man's primary hypertension and it is debated whether this reflects increased permeability or merely a raised capillary pressure. To elucidate this problem, maximally vasodilated hindquarters of spontaneously hypertensive rats (SHR) and normotensive controls (NCR) were perfused in parallel at constant flow with dextran, horse serum or mixtures of the two, using labelled albumin as indicator of capillary permeability to macromolecules. By equal increases of venous pressure modest filtration was maintained during one hour, after which the edema and its albumin content were determined.--There was less edema in SHR, reflectin a slightly lower postcapillary resistance and a much higher precapillary resistance compared with NCR, which here resulted in a lower capillary pressure in SHR. In both SHR and NCR the presence of dextran slightly enhanced the capillary filtration coefficient but increased albumin permeability up to tenfold, also after antihistamine drugs. However, for each perfusate the SHR capillaries were, if anything, slightly less permeable to albumin than the NCR ones.--The results suggest that the enhanced transcapillary passage of plasma proteins in primary hypertension reflects an increased capillary pressure in some circuit(s), probably mainly skeletal muscle, resulting from the functional balance in vivo between the pre- and postcapillary resistances.

Animals↗

The influence of rheological and collapse factors on pre- and post-capillary flow resistances in the skeletal muscle vascular bed of the cat.

The importance of passive-elastic changes of vascular dimensions and shifts in regional effective viscosity for the pre-/postcapillary resistance ratio (RA/RV), and hence mean capillary pressure (PC), was analyzed in cat calf muscles. Reductions of mean venous distending pressure below 6-8 mm Hg induced marked RV increases due to escalating venous collapse. This mechanism tends to delimit the PC reductions and rate of transcapillary fluid absorption during intense precapillary vasoconstriction. Comparisons of RA/RV for erythrocyte suspensions (Hct 40-50) and cellfree perfusates at identical vascular dimensions showed that RA/RV was considerably higher, and PC correspondingly lower, for the erythrocyte suspension except at very low flows. This RA/RV difference increased with increasing flow and at very high flows PC was about 10 mm Hg lower during perfusion with the erythrocyte suspension. These findings apparently diverge from the known influence of the tube radius and linear flow velocity on effective in vitro viscosity of blood. Since distal precapillary and proximal capillary sections, both having smaller diameters than the erythrocytes, are located upstream to the point of filtration-absorption equilibrium, they contribute in this respect to RA. It is therefore suggested that the increasing RA/RV with erythrocyte perfusion, particularly at higher flows, is not due to genuine viscosity factors but to friction losses when cells in "bolus flow" are squeezed through the narrowest precapillary sections.

Animals↗

Are aldehydes in heat-sterilized peritoneal dialysis fluids toxic in vitro?

OBJECTIVE: Chemical analysis of several brands of peritoneal dialysis fluids (PD fluids) has revealed the presence of 2-furaldehyde, 5-HMF (5-hydroxymethylfuraldehyde), acetaldehyde, formaldehyde, glyoxal, and methylglyoxal. The aim of this study was to investigate if the in vitro side effects caused by glucose degradation products, mainly formed during heat sterilization, are due to any of these recently identified aldehydes. DESIGN: Cell growth media or sterile filtered PD fluids were spiked with different concentrations of thealdehydes. MEASUREMENTS: In vitro side effects were determined as the inhibition of cell growth of cultured mouse fibroblasts or stimulated superoxide radical release from human peritoneal cells. RESULTS: Our results demonstrate that the occurrences of 2-furaldehyde, 5-HMF, acetaldehyde, formaldehyde, glyoxal, or methylglyoxal in heat-sterilized PD fluids are probably not the direct cause of in vitro side effects. In order to induce the same magnitude of cell growth inhibition as the heat-sterilized PD fluids, the concentrations of 2-furaldehyde, glyoxal, and 5-HMF had to be 50 to 350 times higher than those quantified in the PD fluids. The concentrations of acetaldehyde, formaldehyde, and methylglyoxal observed in the heat-sterilized PD fluids were closer to the cytotoxic concentrations although still 3 to 7 times lower. CONCLUSION: Since none of these aldehydes caused in vitro toxicity at the tested concentrations, the toxicity found in PD fluids is likely to be due to another glucose degradation product, not yet identified. However, it is possible that these aldehydes may still have adverse effects for patients on peritoneal dialysis.

Acetaldehyde↗

Clinical and physiological effects of a new, less toxic and less acidic fluid for peritoneal dialysis.

OBJECTIVE: To report our first clinical experience with a new continuous ambulatory peritoneal dialysis (CAPD) fluid (PD-Bio), which is nearly devoid of glucose degradation products and has a higher pH (6.3) than conventional peritoneal dialysis (PD) solutions, and to discuss in general terms some acute and long-term effects of conventional acidic solutions containing glucose degradation products. DESIGN: 1) Pilot study on 4 patients investigated using a modified peritoneal equilibration test (PET) and cytobiology parameters. 2) Computer simulation study, assuming that conventional acidic solutions cause vasodilatation and recruitment of capillary surface area initially (during 0-60 minutes) in a PD dwell. PATIENTS: Four stable CAPD patients were chosen in an open cross-over study. After a period of three months using conventional PD fluid, the patients were switched to three months on the new PD fluid. RESULTS: Cancer antigen 125 increased significantly, and patients with discomfort/infusion pain during the control period improved during the period with the new fluid. No significant changes were observed in mass-transfer coefficients or drained volumes with the new solution. PH in the effluent dialysis was, however, higher for PD-Bio at all times during a two-hour dwell. In the computer simulation study, a less acidic solution caused an initially lower rate of glucose dissipation and improved ultrafiltration (UF) after a four-hour dwell, as compared to a conventional PD solution. CONCLUSIONS: A new, differently produced, less toxic and less acidic PD fluid (PD-Bio) seems to be better tolerated than a conventional acidic solution with respect to discomfort/infusion pain. Theoretically, neutralized solutions should show slightly improved UF profiles over conventional acidic solutions, according to the computer simulation analysis. Furthermore, it is speculated that a neutral, less acidic, less toxic fluid would cause less interstitial-mesothelial alterations and less impairment of UF capacity than conventional solutions during long-term CAPD.

CA-125 Antigen↗

Limitation of small-solute exchange across the visceral peritoneum: effects of vibration.

OBJECTIVE: To evaluate the importance of the peritoneal membrane diffusion resistances to small solutes prevailing outside the capillaries in the visceral versus the parietal peritoneum during acute peritoneal dialysis (PD). DESIGN: Experimental study in anesthetized Wistar rats undergoing PD in a single exchange (120 min) using 1.36% Dianeal as dialysis fluid. Vibration, using a standard laboratory shaker at 10 Hz, was used to induce dialysate mixing and reduce the impact of "unstirred layers" in intact and eviscerated rats. Nonvibrated rats served as controls. MEASUREMENTS: The mass transfer area coefficient (PS) for chromium 51-ethylenediamine tetraacetic acid (51 Cr-EDTA), continuously infused intravenously, the plasma-to-peritoneal clearance (Cl-->D) of radioiodinated (125I) serum albumin (human)(RISA), as well as the total clearance out of the peritoneal cavity (Cl) of Evans blue labeled albumin, given as an intraperitoneal volume marker, and the portion of this Cl reaching the plasma per unit time (Cl-->P) were assessed. RESULTS: In intact rats there was a marked increase in PS for 51 Cr-EDTA, from 0.297 +/- 0.036 mL/min to 0.642 +/- 0.122 mL/min (n = 7, p < 0.01), and a moderate increase in Cl and Cl-->D, from 37.6 +/- 1.3 microL/min to 63.3 +/- 9.0 microL/min and from 6.04 +/- 0.51 microL/min to 9.54 +/- 0.93 microL/min (n = 7, p < 0.05), respectively, upon vibration. However, the plasma absorption clearance of albumin (Cl-->P) was unchanged after vibration. Furthermore, in eviscerated rats, vibration caused no significant changes in either of the exchange parameters measured. CONCLUSION: In conclusion, the visceral peritoneal transport of small solutes is normally limited by the presence of diffusion resistance outside the capillaries, which may be markedly reduced by "stirring" of the dialysate by vibration. Normally, the parietal, rather than the visceral, peritoneum is the major site for small-solute mass transfer in stationary animals. However, the visceral peritoneum apparently becomes increasingly important after stirring. The moderate increases in transperitoneal clearances of macromolecules occurring upon vibration, which were quite unexpected, indicate that vibration may also increase the dialysate/peritoneal membrane contact and/or cause some recruitment of capillaries.

Animals↗

Effects of acidity, glucose degradation products, and dialysis fluid buffer choice on peritoneal solute and fluid transport in rats.

OBJECTIVE: To evaluate the effects of acidity, glucose degradation products (GDP), and different solution buffer systems on solute and fluid transport during acute peritoneal dialysis (PD) in rats. DESIGN: Dialysis fluid (16 mL) containing 2.5% glucose as the osmotic agent was instilled intraperitoneally in Wistar rats (280 g) via a thin catheter in dwells lasting 4 hours. Blood and dialysis fluid samples (25 microL) were taken for measurement of glucose, sodium, and radioactive markers. The mass transfer area coefficient (MTAC or PS) for glucose and for 51Cr-EDTA (given as an intravenous infusion) and the peritoneal clearance (Cl) of 125I albumin (RISA), as well as the clearance of RISA to plasma (Cl --> P) were assessed for a commercial, heat-sterilized, acidic PD solution (2.5% glucose, pH 5.5; Gambrosol, Gambro, Lund, Sweden), containing GDP, and for four filter-sterilized solutions containing either lactate (40 mmol/L, pH 5.5 or 7.2), bicarbonate (38 mmol/L, pH 7.2), or pyruvate (40 mmol/L, pH 7.2) as buffers and being devoid of GDP. RESULTS: The initial pH of the acidic solutions increased rapidly, and attained physiological levels within 40 minutes. The initial drop of sodium, which is expected during the first part of the dwell, was significantly more pronounced with neutral than with acidic lactate. The PS for glucose and 51Cr-EDTA were slightly, but significantly, higher with the acidic and heat-sterilized solution (Gambrosol) than with the neutral, sterile-filtered lactate-buffered solution (p < 0.01), especially early during the dwell. Such an increase may be due to initial vasodilatation, and hence, recruitment of capillaries by the combination of acidity and GDP. However, there were no significant differences with respect to small solute PS values among sterile-filtered solutions, regardless of the presence of acidity or of buffer choice. CONCLUSION: There were no major differences in fluid and solute transport among sterile-filtered PD solutions having differing buffer systems and pH. Neither were there any effects of GDP alone. However, the combination of a low pH and the presence of GDP in the PD solutions seemed to cause significant increases in peritoneal small solute transport.

Animals↗

Clearance of tracer albumin from peritoneal cavity to plasma at low intraperitoneal volumes and hydrostatic pressures.

OBJECTIVE: To assess the clearance of radiolabeled tracer albumin (RISA) from peritoneal cavity to plasma (Cl-->P) in rats under essentially "normal" conditions, that is, when intraperitoneal hydrostatic pressure (IPP) is subatmospheric and the intraperitoneal (IP) "free" fluid volume (IPV) is low. METHODS: A volume of 0.3 mL of RISA was injected IP into anesthetized Wistar rats (wt = 300 g) when the IPV was approximately 2 mL (normal) or the IPV was approximately 10 mL, and IPP was either -1.8 mmHg (normal) or +1.5 mmHg (produced by an external cuff). Plasma samples (25 microL) were obtained repeatedly during the dwell, which lasted 30-300 min, after which the peritoneal cavity was opened to recover the IPV and residual IP RISA activity. The Cl-->P was assessed as the mass transfer of RISA into plasma, occurring per unit time, divided by the calculated mean IP RISA concentration (CD). The interstitial RISA space was measured as the mass of RISA accumulated, per unit tissue weight, in peritoneal tissue samples divided by the CD. RESULTS: A markedly lower Cl-->P (2.47+/-0.67 microL/min), as well as total RISA clearance out of the peritoneal cavity (Cl), was found under "normal" conditions (an IPV of approximately 2 mL and an IPP of approximately -1.8 mmHg) compared to the situation during peritoneal dialysis (an IPV of approximately 20 mL and an IPP of +1 mmHg). Furthermore, the interstitial RISA space increased linearly over time even at negative IPPs and at an unchanging peritoneal interstitial fluid volume. At a low (normal) IPV the Cl-->P did not increase significantly with elevating IPP, and increased only marginally when tracer distribution was improved by artificial vibration of the rats. However the Cl-->P increased when larger volumes were infused to increase the total IPV. CONCLUSIONS: It is concluded that the Cl-->P and Cl at low IPPs and IPVs are not as high as during peritoneal dialysis. Increases in Cl-->P were, however, coupled to increases in IPV. This highlights the importance of the IPV per se and of a sufficient IP tracer distribution for direct lymphatic absorption to be efficient.

Animals↗