Karin Bergling1, Giedre Martus2, Carl Oberg3. 1. K Bergling, Department of Clinical Sciences Lund, Skåne University Hospital Lund, Lund, Sweden karin.bergling@med.lu.se. 2. G Martus, Department of Clinical Sciences Lund, Skåne University Hospital Lund, Lund, Sweden. 3. C Oberg, Department of Clinical Sciences Lund, Skåne University Hospital Lund, Lund, Sweden.
Abstract
Background: Harmful glucose exposure and absorption remain major limitations of peritoneal dialysis. We previously showed that inhibition of sodium glucose cotransporter 2 did not affect glucose transport during peritoneal dialysis in rats. However, more recently we found that phlorizin, a dual blocker of sodium glucose co-transporter 1 and 2, reduces glucose diffusion in peritoneal dialysis. Therefore, either inhibiting sodium glucose co-transporter 1 or blocking facilitative glucose channels by phlorizin metabolite phloretin would reduce glucose transport in peritoneal dialysis. Methods: We tested a selective blocker of sodium glucose co-transporter 1, mizagliflozin, as well as phloretin, a non-selective blocker of facilitative glucose channels, in an anesthetized Sprague-Dawley rat model of peritoneal dialysis. Results: IIntraperitoneal phloretin treatment reduced glucose absorption by more than 30% and resulted in a more than 50% higher ultrafiltration rate compared to control animals. Sodium removal and sodium clearances were similarly improved, whereas the amount of ultrafiltration per mmol sodium removed did not differ. Mizagliflozin did not influence glucose transport or osmotic water transport. Conclusions: Taken together, our present and previous results indicate that blockers of facilitative glucose channels may be a promising target for reducing glucose absorption and improving ultrafiltration efficiency in peritoneal dialysis.
Background: Harmful glucose exposure and absorption remain major limitations of peritoneal dialysis. We previously showed that inhibition of sodium glucose cotransporter 2 did not affect glucose transport during peritoneal dialysis in rats. However, more recently we found that phlorizin, a dual blocker of sodium glucose co-transporter 1 and 2, reduces glucose diffusion in peritoneal dialysis. Therefore, either inhibiting sodium glucose co-transporter 1 or blocking facilitative glucose channels by phlorizin metabolite phloretin would reduce glucose transport in peritoneal dialysis. Methods: We tested a selective blocker of sodium glucose co-transporter 1, mizagliflozin, as well as phloretin, a non-selective blocker of facilitative glucose channels, in an anesthetized Sprague-Dawley rat model of peritoneal dialysis. Results: IIntraperitoneal phloretin treatment reduced glucose absorption by more than 30% and resulted in a more than 50% higher ultrafiltration rate compared to control animals. Sodium removal and sodium clearances were similarly improved, whereas the amount of ultrafiltration per mmol sodium removed did not differ. Mizagliflozin did not influence glucose transport or osmotic water transport. Conclusions: Taken together, our present and previous results indicate that blockers of facilitative glucose channels may be a promising target for reducing glucose absorption and improving ultrafiltration efficiency in peritoneal dialysis.
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