Effects of Renin-Angiotensin-Aldosterone System Blockade on Chlorhexidine Gluconate-Induced Sclerosing Encapsulated Peritonitis in Rats

Abstract

Sclerosing encapsulated peritonitis (SEP) is a rare complication of long term peritoneal dialysis. Renin-angiotensin-aldosterone system (RAAS) may play a role in the development of peritoneal fibrosis in CAPD patients. We aimed to evaluate the effect of aliskiren, valsartan, and aliskiren+valsartan therapy on SEP. The study included 30 Wistar albino rats which were divided into five groups: I (Control) SF solution i.p.; II (CG group) chlorhexidine gluconate i.p.; III aliskiren oral plus CG i.p.; IV valsartan oral plus CG i.p.; and V aliskiren oral, valsartan oral and CG i.p. On the twenty-first day, all of the rats were sacrificed. All of the groups were analyzed in terms of peritoneal thickness, degree of inflammation, vasculopathy, neovascularization and fibrosis. Also, the parietal peritoneal tissue samples were evaluated for matrix metalloproteinase 2 (MMP-2) using the ELISA method. Peritoneal thickness and fibrosis scores were lower in the valsartan group compared to the CG group (P<0.05). Peritoneal fibrosis scores were lower in the aliskiren group compared to CG group (P<0.05) but no difference was observed between the peritoneal thickness scores of the two groups (P>0.05). Tissue MMP-2 levels were significantly higher in the CG group compared other groups (P<0.05). There were no statistically significant differences between the aliskiren, valsartan and aliskiren+valsartan groups according to the tissue MMP-2 levels. Due to the antifibrotic properties of valsartan, it is thought to be a possible choice to prevent SEP development. We found no positive impact of aliskiren or aliskiren+valsartan combination compared to valsartan alone. © 2012 The Authors. Therapeutic Apheresis and Dialysis © 2012 International Society for Apheresis.