JPH01151462A - Fluid for peritoneal perfusion - Google Patents

Abstract

PURPOSE:To contribute to stabilize tissue components without causing the deterioration of peritoneal functions for the patient who have been treated by peritoneal dialysis for a long while, by adding such an amount of a mucopolysaccharide as to sufficiently prevent the deterioration of peritoneal functions to peritoneal perfusion. CONSTITUTION:Fluid used for peritoneal perfusion is prepared, which includes a mucopolysaccharide, a physiological salt coexisting with blood by osmotic pressure and a carbohydrate nutriment. The carbohydrate nutriment used may be 0.1-5g/l glucose or 0.3-4g/dl glycerol. The mucopolysaccharide added is 0.1-10wt.%, and at least one selected from the following: chondroitin sulfuric acid A, B or C, heparin sulphate, hyaluronic acid, heparin, keratin sulfate etc. The physiological salt which can coexist with blood by osmotic pressure, is in almost the same concentration as that of serum, and is, for example, a potassium salt, a sodium salt, a calcium salt, a magnesium salt or a chloride.

Description

DETAILED DESCRIPTION OF THE INVENTION (Field of Industrial Application) The present invention relates to a peritoneal perfusate used during peritoneal dialysis, and particularly to a peritoneal perfusate that improves the decline in peritoneal function and contributes to stabilizing tissue components.

(Prior art) Recently, peritoneal perfusion method (
CAPD method or IPD method). This therapy involves inserting a tube into the body, injecting the medicinal solution in the container into the body by the action of gravity, and then draining the medicinal solution out of the body by the action of gravity after a certain period of time, which is continued over a long period of time. However, compared to dialysis using an artificial kidney, it requires less equipment and equipment, requires less time, and is less expensive to treat, so it has been designated as Note [J].

However, in this therapy, a peritoneal perfusate containing electrolytes and sugar is used as a medicinal solution, and the composition is mainly electrolytes (Na, Ca, Mg, CQ), acid/base balance corrector (
lactic acid alkali salt, acetate Na salt), and an osmotic pressure additive (glucose). Furthermore, K is free so that it can be adjusted when used. It is possible to remove water by applying a higher osmotic pressure than blood, but in cases of continuous long-term use, the function of the peritoneum gradually declines, and the water removal effect and waste removal effect decreases, making it difficult to continue therapy. There are also cases where this is not possible. Although the cause of this has not yet been determined, it is generally thought that mechanical stress or stimulation to the peritoneum causes detachment of the peritoneal tissue, fibrillation (thickening) of the peritoneum, and damage to mesothelial cells.

(Problems to be Solved by the Invention) The present inventor has completed the present invention as a result of various studies to enable this peritoneal perfusion method to be used continuously over a long period of time without deteriorating the function of the peritoneum. An object of the present invention is to provide a peritoneal perfusion solution that can contribute to the stabilization of tissue components without causing a decline in peritoneal function to patients undergoing long-term dialysis therapy using the peritoneal perfusion method.

(Means for Solving the Problems) That is, the present invention is a peritoneal perfusate characterized by containing a mucopolysaccharide substance, and more specifically, a mucopolysaccharide substance,
It is a peritoneal irrigation fluid consisting of physiological salts and carbohydrate nutrients that are osmotically compatible with the blood.

Conventional peritoneal irrigation fluids use nutritional substances such as glucose and lactic acid, which makes the blood alkaline, but in the present invention, mucopolysaccharide substances are further added to such peritoneal irrigation fluids. This is what I did. That is, to specifically explain the present invention, examples of carbohydrate nutritional substances in the present invention include glucose and glycerol,
The proportion is 0.1 to 5 g/l for glucose and 0.3 to 4 g/d Q for glycerol. Examples of mucopolysaccharide substances include chondroitin sulfate A, chondroitin sulfate B, chondroitin sulfate C,
At least one of heparan sulfate, hyaluronic acid, hepason, keratan sulfate, etc. is used, and the amount used is preferably 0.1 to 10% by weight.

Furthermore, in the present invention, the salts that can osmotically coexist with blood include salts that are approximately isotonic (almost the same concentration) as the serum concentration, and physiological salts include potassium salts, These include sodium salts, calcium salts, magnesium salts, and chlorides.

Specifically, the osmotic pressure of the liquid is 280 to 800 mOsm.
/Q, and the liquid circle (is 4 to 7.40) Normally, the pH of renal thrombosis patients generally becomes acidosis, so
A weakly alkaline substance such as sodium lactate or sodium acetate is added to the peritoneal perfusate as an alkalizing agent, and the weakly alkaline substance is introduced into the peritoneum from the perfusate to maintain or improve the pH around neutrality.

Therefore, in the present invention, by adding mucopolysaccharide to the peritoneal perfusate in an amount that can prevent a decline in peritoneal function, it stabilizes and maintains the components of mesothelial cells, acts as a lubricant, and has a water removal effect. Alternatively, it prevents detachment and fibrosis of the peritoneal tissue, which is considered to be one of the causes of a decline in the waste removal effect.

Next, the present invention will be explained in more detail with reference to Examples.

(Example) Per water IR, 5.82 g of sodium chloride, 0.294 g of calcium chloride, 0.151 g of magnesium chloride,
A peritoneal perfusion solution consisting of 3.92 g of sodium lactate, 10 g of glucose, and 10 g of chondroitin sulfate is prepared (this solution is referred to as CAPD-3). On the other hand, as a control example, a solution was prepared in which chondroitin sulfate was removed from the components of the peritoneal perfusate (this solution was referred to as CAPD-400),
Continuous administration into the abdomen and vagina of domestic rabbits was attempted. New Sealant White rabbits were used as the administration method, and the administration was carried out using an indwelling needle from the lower abdomen of the rabbit, and the administration was carried out continuously for 28 days at an administration rate of 50 mQ/min. The dosage was 90 m12/kg, which can be administered daily. There were 5 animals in each male and female group, and evaluation was based on histological findings through anatomical examination. The result was as per the law.

(Results) - Thickening due to Yamaguchi tissue and fibrosis of mesenteric tissues such as the occlumina and mesentery was observed in 4/10 animals in the CAPD-400 group, but not in the CAPD-3 group.

■Granulation tissue formation and fibrotic thickening of the peritoneum (diaphragm, abdominal wall) were observed in 6/10 animals in the CAPD-400 group;
It was not observed in the CAPD-3 group.

(Effects) The peritoneal perfusate of the present invention is particularly suitable for continuous peritoneal perfusion (CAPD)
), and by incorporating mucopolysaccharides that contribute to stabilizing tissue components, it is possible to prevent the effects on the peritoneum due to long-term continuous administration, especially the decline in peritoneal function, resulting in a long-term stable CAPD. Can be done.

Claims (1)

[Scope of Claims] 1. A peritoneal perfusate characterized by containing a mucopolysaccharide substance. 2. The peritoneal perfusate according to claim 1, which contains a mucopolysaccharide substance, physiological salts and carbohydrate nutritional substances that can osmotically coexist with blood. 3 The mucopolysaccharide substances are chondroitin sulfate A, chondroitin sulfate B, chondroitin sulfate C, heparan sulfate,
The peritoneal irrigation fluid according to claim 1, which is at least one of hyaluronic acid, heparin, and keratan sulfate. 4. The peritoneal perfusate according to claim 1, wherein the concentration of the mucopolysaccharide substance is 0.1 to 10% by weight. 5. The peritoneal perfusate according to claim 2, wherein the physiological salt that can osmotically coexist with blood is at least one of potassium salt, sodium salt, calcium salt, magnesium salt, and chloride. 6. The peritoneal perfusate according to claim 2, wherein the carbohydrate nutritional substance is glucose and/or glycerol. 7. The peritoneal perfusate according to claim 6, wherein the concentration of glucose is 0.1 to 5 g/l. 8. The peritoneal perfusate according to claim 6, wherein the concentration of glycerol is 0.3 to 4 g/l. 9. The peritoneal irrigation solution according to claim 1, wherein the osmotic pressure of the solution is 280 to 800 mOsm/l. 10 Claim 1 in which the pH of the liquid is 4 to 7.4
Peritoneal irrigation fluid as described in section. 11. The peritoneal irrigation fluid according to claim 1, which contains an alkaline agent. 12 Sodium 130-140 mEq/l, chlorine 90
Peritoneal irrigation fluid according to claim 1, comprising ~120 mEq/l, calcium 0-6 mEq/l and magnesium 0-4 mEq/l.