Cardiovascular Effects of Peritoneal Dialysis in a Rat Model of End Stage Renal Disease
Authors: Nasci Victoria , Goodreau Kathryn , Kriegel Alison 
Published: June 2021

In the US more than 700,000 people suffer from end stage renal disease (ESRD). Of those, 97.5% are reliant on dialysis. Among dialysis patients, cardiovascular (CV) related events are the leading cause of death; in fact, this population has a 20‐fold higher CV related mortality. Despite therapeutic advancements the continued, and often worsening, CVD following the onset of dialysis treatment poses an interesting clinical challenge that necessitates further studies focused on elucidating the effects of dialysis on CV function. Based on clinical reports, we hypothesized that peritoneal dialysis (PD) would not improve CV outcomes in the 5/6 nephrectomy model of cardiorenal syndrome. We performed 5/6Nx (n=12), or sham surgery (n=13), on 10 week old male Sprague‐Dawley rats. Peritoneal catheters were implanted in all animals 4 weeks post‐surgery. PD was initiated 3 days later in some of the 5/6Nx (n=7) and sham (n=7) animals (15ml [Baxter Dianeal PD‐2] 15‐minute dwells 3x per day). Echocardiography was performed at baseline, 4, and 7 weeks after the initial surgery to evaluate left ventricle (LV) remodeling and function. At week 7 pressure volume analysis was performed prior to plasma and tissue collection. Statistical significance of all data was determined via two‐way ANOVA. Plasma creatinine was increased by 5/6Nx (5/6Nx 1.35 ± 0.38 vs. sham 0.63 ± 0.09; p <0.05). Chronic PD had no effect on plasma creatinine in sham animals but attenuated the rise in 5/6Nx (5/6Nx 1.35 ± 0.38 vs. 5/6Nx + PD 1.00 ± 0.10; p <0.05). PD does not alter kidney weight in sham animals nor does it alter remnant kidney weight in 5/6Nx. PD trended to decrease heart weight in both sham and 5/6Nx animals (sham 0.41 ± 0.02 vs sham + PD 0.35 ± 0.02 and 5/6Nx 0.46 ± 0.05 vs 5/6Nx + PD 0.42 ± 0.03; N.S.). LV ventral wall thickness increases in 5/6Nx animals compared to sham (5/6Nx 3.49 ± 0.14 vs sham 2.99 ± 0.04; p <0.05). PD did not alter wall thickness in sham animals but tended to attenuate the increase observed in 5/6Nx (5/6Nx 3.49 ± 0.14 vs 5/6Nx + PD 3.18 ± 0.15; N.S.). 5/6Nx animals have an increased ejection fraction (EF) compared to sham (5/6Nx 84.65 ± 2.49 vs sham 75.97 ± 1.06 and 5/6Nx 47.08 ± 2.88 vs sham 37.89 ± 0.90, respectively; p <0.05). There was no change in EF induced by PD in sham animals, but PD prevents the increase in EF in 5/6Nx (5/6Nx 84.65 ± 2.49 vs 5/6Nx + PD 78.91 ± 1.25, respectively; p <0.05). Acute systolic blood pressure (BP) was unchanged by 5/6Nx. PD tended to increase BP in 5/6Nx animals (5/6Nx 122.04 ± 11.36 vs 5/6Nx + PD 135.44 ± 5.82; N.S.). These data combined suggest that PD may influence CV outcomes in CKD, however it is unclear if these changes would be beneficial or detrimental if the treatment were extended for a longer period of time. The differences in wall thickness suggests PD is possibly altering hypertrophic growth signaling and preventing cardiac remodeling in response to reduced renal mass. However, increased BP may hint to other confounding factors that may be responsible for the increased CV mortality in this population. These data indicate further studies are necessary to understand the effects of dialysis on CV function, as well as other physiological functions, in order to improve dialysis treatment and improve clinical outcomes for ESRD patients.Support or Funding InformationAHA ‐ 18PRE34000045This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.