The protective effect of paricalcitol, NAC and carvedilol therapies on peritoneal fibrosis: A comperative experimental study

End stage renal disease (ESRD) is an increasing global health problem accompanied with high annual rates of mortality and cardiovascular morbidity. Although, renal transplantation is recommended as a gold standard therapy, lack of the sufficient greft donor for renal transplantation may cause dialysis modalities as a mandatory renal replacement therapies for these certain patient population. Peritoneal dialysis is succesfull treatment modality for ESRD patients. But peritoneal membrane structure may be diminished due to the long term use of high glucose concentrate peritoneal dialysis fluids due to the peritonitis attacks and other pathologies. Peritoneal fibrosis is the most important cause for the development of diminished peritoneal filtration barrier. Here in this tudy, we aimed to examine to compare the protective effect of paricalcitol, carvedilol and N-acetyl cystein (NAC) therapies against to the peritoneal fibrosis.A total of 36 rats were included this experimental protocol in a follow up period of 21 days by dividing six groups which included six rats in each subgroups. The mixed of 10 ml/kg/day %0,1 clorhexidin gluconate (CH) (Drogsan Drugs, Balgat, Ankara) + %15 ethanol + % 0.09 NACL solution were administered to develop peritoneal fibrosis in each rats. Durıng 21 days of study period, 0,2 mcg/kg/day paricalcitol were injected to the nape of the rats in paricalcitol group every day. 450 mg/kg/day NAC were administered via oral way by mixing drinking water in NAC subgroup and also 10 mg/kg/day carvedilol were administered orally in carvedilol group every day. At the end of the study period, serum samples were obtained to study TGF- ß1 levels. Also parietal peritoneal membrane samples were assessed histopathologically to demonstrate the magnitude of peritoneal fibrosis.Results; TGF- ß1 levels were significantly lower in NAC group compared the other subgroups (p<0.05). When we analysed the peritoneal samples as histopathologically, NAC and carvedilol subgroups showed significantly lower scores of peritoneal fibrosis, peritoneal thickness and vascularisation acompanied with lower inflammation. Although, lower levels of peritoneal thickness were observed in paricalcitol group, no distinctive protective effect were seen on other histopathologic structure.Here in this study, we have identified NAC and carvedilol therapies have favorable effects for the protection of peritoneal fibrosis. Further clinical studies are necessary to better understand the protective effects of NAC and carvedilol therapies on peritoneal fibrosis whether these certain agents may take place in rutin clinical practice as slowen therapies for peritoneal fibrosis in peritoneal dialysis patients.