Effect of Intraperitoneal Administration of Heparin on Advanced Glycation End-Products in Capd

Objective To evaluate the effect of intraperitoneal (IP) administration of heparin on clearance of advanced glycation end-products (AGEs) and peritoneal dialysis efficiency.Design Sequential self-controlled intervention study.Setting University hospital, Department of Nephrology.Patients and Methods Pyrraline, urea, and creatinine levels in plasma and dialysate, along with AGE-derived fluorescence intensity (excitation, 370 nm; emission, 440 nm) in dialysate were measured 0, 30, and 60 days after IP administration of heparin in 11 patients on continuous ambulatory peritoneal dialysis (CAPD). Pyrraline levels were determined by ELISA.Results Heparin induced a significant decrease in plasma pyrraline levels; the values on days 0, 30, and 60 were 162.0 ± 89.8 μmol/L, 101.1 ± 32.1 mmol/L ( p < 0.01), and 94.0 ± 19.8 μmol/L ( p < 0.001), respectively. Heparin also induced a tendency of increased dialysate pyrraline levels and a significant increase in AGE-derived fluorescence intensity in the dialysate. The values for the latter on days 0, 30, and 60 were 51.0 ± 9.3 AU (arbitrary units/ mg of collagen), 73.5 ± 16.0 AU ( p < 0.001), and 65.6 ± 15.5 AU ( p < 0.01), respectively. Furthermore, heparin administration resulted in a significant ( p < 0.01) increase in the dialysate/plasma ratio of urea (means 0.80, 0.90, and 0.94 on days 0, 30, and 60, respectively).Conclusion These results suggest that a beneficial effect of IP administration of heparin is in part due to its action on AGE kinetics, supporting a potential preventive strategy for peritoneal membrane distortion in CAPD.