AI Article Synopsis
- Bacterial peritonitis can harm the peritoneum in patients on peritoneal dialysis, and the renin-angiotensin-aldosterone system may contribute to this damage.
- In a study with 40 rats, different treatment groups received bacteria along with either irbesartan, spironolactone, or both, while a control group received only dextran beads.
- Results showed that the treatment groups (BI, BS, BIS) had significantly less peritoneal damage compared to the bacteria-only group, indicating that irbesartan and spironolactone may help reduce peritoneal injury from bacterial infections.
Article 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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