Liposome-supported peritoneal dialysis in the treatment of severe hyperammonemia: An investigation on potential interactions
Abstract
Peritoneal dialysis (PD) performed with transmembrane pH-gradient
liposomes was reported to efficiently remove ammonia from the
body, representing a promising alternative to current
standard-of-care for patients with severe hepatic encephalopathy.
In this study, we further characterized the properties of
liposome-supported peritoneal dialysis (LSPD) by 1) assessing its
in-use stability in the presence of ascitic fluids from
liver-disease patients; 2) investigating its interactions with
drugs that are commonly administered to acute-on-chronic liver
failure patients; and 3) analyzing the in vivo extraction profile
of LSPD. We found that LSPD fluid maintained its in vitro ammonia
uptake capability when combined with ascitic fluids. The
co-incubation of selected drugs (e.g., beta-blockers,
antibiotics, diuretics) with LSPD fluids and ammonia resulted in
limited interaction effects for most compounds except for two
fluoroquinolones and propranolol. However, considering the
experimental set-up, these results should be interpreted with
caution and confirmatory drug-drug interaction studies in a
clinical setting will be required. Finally, metabolite-mapping
analysis on dialysates of LSPD-treated rats revealed that the
liposomes did not remove important metabolites more than a
conventional PD fluid. Overall, these findings confirm that LSPD
is a potentially safe and effective approach for treating
hyperammonemic crises in the context of acute-on-chronic liver
failure. Mehr anzeigen
Publikationsstatus
publishedExterne Links
Zeitschrift / Serie
Journal of Controlled ReleaseBand
Seiten / Artikelnummer
Verlag
ElsevierThema
Hyperammonemia; Liposomes; Peritoneal dialysis; Acute-on-chronic liver failure; Chronic kidney diseaseOrganisationseinheit
08839 - Zamboni, Nicola (Tit.-Prof.)
03811 - Leroux, Jean-Christophe / Leroux, Jean-Christophe
03713 - Sauer, Uwe / Sauer, Uwe