Stimulation of peritoneal synthesis of vasoactive prostaglandins during peritonitis in patients on continuous ambulatory peritoneal dialysis

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Abstract
The peritoneal generation of arachidonic acid metabolites was studied in 8 patients with end-stage renal disease undergoing continuous ambulatory peritoneal dialysis (CAPD) during infection-free periods and during bacterial peritonitis. The prostacyclin metabolite 6-keto-PG[prostaglandin]F1.alpha. was the major prostanoid generated by human peritoneal mesothelium (1090 ng (6h)-1, SEM [standard error of the mean] 86, n = 8) followed by lesser amounts of PGE2 (142 ng (6h)-1, SEM 26, n = 8), PGF2.alpha. (162 ng (6h)-1, SEM 27, n = 8) and TXB2 [thromboxane] (59 ng (6 h)-1, SEM 5, n = 8). During peritonitis a significant increase of all prostaglandins and TXB2 occurred (P < 0.001). The ratio of the vasodilating prostaglandins and their metabolites (PGF2 and 6-keto-PGF1.alpha.) to the vasoconstrictors and their metabolites (PGF2.alpha. and TXB2) increased from 6.6-10.5 during peritoneal inflammation. Augmented peritoneal clearances of creatinine and urea, and increased losses of proteins during peritonitis as well as the enhanced peritoneal generation of prostanoids were reduced to basal values by adequated antibiotic therapy. The increased peritoneal blood flow during peritonitis, probably responsible for the observed changes of peritoneal transport properties, may be induced by a change in the ratio of vasoactive prostaglandins generated by peritoneal mesothelial cells.