The effects of ouabain and potassium on peritoneal fluid and solute transport characteristics.

BACKGROUND

We reported anomalous transport characteristics of potassium during experimental peritoneal dialysis in rats and suggested that mechanisms of peritoneal potassium transport could be other than simple passive transport. Intracellular transport of potassium in cultured human mesothelial cells was reported to be regulated by three different pathways, such as channels blocked by ouabain, channels blocked by furosemide, and other.

OBJECTIVE

To investigate the effect of ouabain on peritoneal potassium and water transport characteristics.

METHODS

A single 4-hour peritoneal dwell was performed in 28 Sprague-Dawley rats. To minimize the diffusive transport of potassium, 4.5 mmol/L of KCl was added into conventional dialysis solution with 3.86% glucose [acidic peritoneal dialysis solution (APD)]. To evaluate the effect of the pH of dialysis solution on the transport of potassium and water, 4 mmol/L of NaOH was added into the potassium-containing study solutions [neutral peritoneal dialysis solution (NPD)]. To evaluate the effect of a potassium channel blocker on peritoneal potassium transport ATPase sensitive Na+-K+-transport inhibitor, ouabain (10(-5) mmol/L) was added to dialysis solutions immediately before the dwell study in eight rats with APD (APD-O) and six rats with NPD (NPD-O). Ouabain was not added in eight and six rats with APD and NPD (APD-C and NPD-C, respectively). They were used as control. Infusion volume was 30 mL. The intraperitoneal volume (V(D)) was estimated by using a volume marker dilution method with corrections for the elimination of volume marker, radioiodinated human serum albumin (RISA), from the peritoneal cavity (K(E)). The diffusive mass transport coefficient (K(BD)) and sieving coefficient (S) were estimated using the modified Babb-Randerson-Farrell model.

RESULTS

V(D) was significantly higher (p < 0.05 from 90 min to 240 min) and K(E) (0.027+/-0.018 mL/min for APD-O, 0.026+/-0.017 mL/min for NPD-O, and 0.030+/-0.022 mL/min for NPD-C, vs 0.058+/-0.030 mL/min for APD-C, p < 0.05 for each) significantly lower during dialysis with APD-O, NPD-O, and NPD-C than with APD-C. The intraperitoneal glucose expressed as a percentage of the initial amount was significantly higher with APD-O, NPD-C, and NPD-O than with APD-C (p < 0.05 from 90 min to 240 min). K(BD) for sodium was higher during dialysis with ouabain than without ouabain, while K(BD) for urea, glucose, and potassium, and S for urea, glucose, sodium, and potassium did not differ between the four groups.

CONCLUSIONS

The physiologic potassium concentration in neutral dialysis solutions and the use of ouabain decreased the intraperitoneal fluid absorption. The diffusive transport coefficient and sieving coefficient for potassium did not differ, while the diffusive transport coefficient for sodium increased during use of ouabain.