Name: a retrograde implantation approach for peritoneal dialysis catheter placement in mice
Uploaded: 2022-07-20T13:00:00
Description: Watch this Scientific Journal Video about A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice at JoVE.com

This work was supported by NIH 1R01HL132325 and R21 DK119740-01 (VCC) and AHA Cardio-oncology SFRN CAT-HD Center grant 857078 (VCC and SL).

For this study, eight female C57BL/6J mice, 8-12 weeks in age, and an average weight of 20 g were used. The mice were housed under standard conditions and were fed with chow and water ad libitum. This study was performed with the approval of the Institutional Animal Care and Use Committee (IACUC), Boston University Medical Center (AN-1549). The procedures described here were performed under sterile conditions.
1. Anesthetize the mouse in an Isoflurane chamber, and inject the ana...

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I., Sequeira, A., Narayan, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Going+home:+Access+for+home+modalities.">Going home: Access for home modalities.</a> Advances in Chronic Kidney Disease. 27 (3), 253-262 (2020).</li><li>van de Luijtgaarden, M. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Trends+in+dialysis+modality+choice+and+related+patient+survival+in+the+ERA-EDTA+Registry+over+a+20-year+period.">Trends in dialysis modality choice and related patient survival in the ERA-EDTA Registry over a 20-year period.</a> Nephrology Dialysis Transplantation. 31 (1), 120-128 (2016).</li><li>Schaefer, F., Warady, B. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Peritoneal+dialysis+in+children+with+end-stage+renal+disease.">Peritoneal dialysis in children with end-stage renal disease.</a> Nature Reviews. Nephrology. 7 (11), 659-668 (2011).</li><li>Gonzalez-Mateo, G. T., Pascual-Anton, L., Sandoval, P., Aguilera Peralta, A., Lopez-Cabrera, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surgical+techniques+for+catheter+placement+and+5/6+nephrectomy+in+murine+Models+of+Peritoneal+Dialysis.">Surgical techniques for catheter placement and 5/6 nephrectomy in murine Models of Peritoneal Dialysis.</a> Journal of Visualized Experiments: JoVE. (137), e56746 (2018).</li><li>Chow, K. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Straight+versus+coiled+peritoneal+dialysis+catheters:+A+randomized+controlled+trial.">Straight versus coiled peritoneal dialysis catheters: A randomized controlled trial.</a> American Journal of Kidney Diseases. 75 (1), 39-44 (2020).</li><li>LaPlant, M. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Peritoneal+dialysis+catheter+placement,+outcomes+and+complications.">Peritoneal dialysis catheter placement, outcomes and complications.</a> Pediatric Surgery International. 34 (11), 1239-1244 (2018).</li><li>Al-Hwiesh, A. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+modified+peritoneal+dialysis+catheter+with+a+new+technique:+Farewell+to+catheter+migration.">A modified peritoneal dialysis catheter with a new technique: Farewell to catheter migration.</a> Saudi Journal of Kidney Diseases and Transplantation. 27 (2), 281-289 (2016).</li><li>Crabtree, J. H., Chow, K. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Peritoneal+dialysis+catheter+insertion.">Peritoneal dialysis catheter insertion.</a> Seminars Nephrology. 37 (1), 17-29 (2017).</li><li>Flessner, M. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Peritoneal+changes+after+exposure+to+sterile+solutions+by+catheter.">Peritoneal changes after exposure to sterile solutions by catheter.</a> Journal of the American Society of Nephrology. 18 (8), 2294-2302 (2007).</li><li>Kowalewska, P. M., Margetts, P. J., Fox-Robichaud, A. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Peritoneal+dialysis+catheter+increases+leukocyte+recruitment+in+the+mouse+parietal+peritoneum+microcirculation+and+causes+Fibrosis.">Peritoneal dialysis catheter increases leukocyte recruitment in the mouse parietal peritoneum microcirculation and causes Fibrosis.</a> Peritonial Dialysis International: Journal of the International Society for Peritonial Dialysis. 36 (1), 7-15 (2016).</li><li>Kowalewska, P. M., Patrick, A. 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V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tryptophan+metabolites+suppress+Wnt+pathway+and+promote+adverse+limb+events+in+CKD+patients.">Tryptophan metabolites suppress Wnt pathway and promote adverse limb events in CKD patients.</a> The Journal of Clinical Investigation. 132 (1), (2021).</li><li>Belghasem, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Metabolites+in+a+mouse+cancer+model+enhance+venous+thrombogenicity+through+the+aryl+hydrocarbon+receptor-tissue+factor+axis.">Metabolites in a mouse cancer model enhance venous thrombogenicity through the aryl hydrocarbon receptor-tissue factor axis.</a> Blood. 134 (26), 2399-2413 (2019).</li><li>Krediet, R. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+peritoneal+membrane+in+chronic+peritoneal+dialysis.">The peritoneal membrane in chronic peritoneal dialysis.</a> Kidney International. 55 (1), 341-356 (1999).</li><li>Gonzalez-Mateo, G. T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chronic+exposure+of+mouse+peritoneum+to+peritoneal+dialysis+fluid:+structural+and+functional+alterations+of+the+peritoneal+membrane.">Chronic exposure of mouse peritoneum to peritoneal dialysis fluid: structural and functional alterations of the peritoneal membrane.</a> Peritonial Dialysis International: Journal of the International Society for Peritonial Dialysis. 29 (2), 227-230 (2009).</li><li>Sukul, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Patient-reported+advantages+and+disadvantages+of+peritoneal+dialysis:+results+from+the+PDOPPS.">Patient-reported advantages and disadvantages of peritoneal dialysis: results from the PDOPPS.</a> BMC Nephrology. 20 (1), 116 (2019).</li><li>Lu, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+method+for+islet+transplantation+to+the+omentum+in+mouse.">A method for islet transplantation to the omentum in mouse.</a> Journal of Visualized Experiments: JoVE. (143), e57160 (2019).</li><li>Gotloib, L., Wajsbrot, V., Shostak, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+short+review+of+experimental+peritoneal+sclerosis:+from+mice+to+men.">A short review of experimental peritoneal sclerosis: from mice to men.</a> The International Journal of Artificial Organs. 28 (2), 97-104 (2005).</li><li>Tateda, K., Matsumoto, T., Miyazaki, S., Yamaguchi, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lipopolysaccharide-induced+lethality+and+cytokine+production+in+aged+mice.">Lipopolysaccharide-induced lethality and cytokine production in aged mice.</a> Infection and Immunity. 64 (3), 769-774 (1996).</li><li>Vila Cuenca, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Differences+in+peritoneal+response+after+exposure+to+low-GDP+bicarbonate/lactate-buffered+dialysis+solution+compared+to+conventional+dialysis+solution+in+a+uremic+mouse+model.">Differences in peritoneal response after exposure to low-GDP bicarbonate/lactate-buffered dialysis solution compared to conventional dialysis solution in a uremic mouse model.</a> International Urology and Nephrology. 50 (6), 1151-1161 (2018).</li><li>Penar, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Selected+indices+of+peritoneal+fibrosis+in+patients+undergoing+peritoneal+dialysis.">Selected indices of peritoneal fibrosis in patients undergoing peritoneal dialysis.</a> Postepy Higieny Medycyny Doswiadczalnej (Online). 63, 200-204 (2009).</li><li>Yung, S., Chan, T. 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Three murine models of PD are described. This includes a blind puncture of the peritoneal surface, an open-permanent system, and a closed system10. The blind puncture of the peritoneal surface involves direct peritoneal access similar to intraperitoneal injections but does not allow drainage of dialysate. Being a blinded procedure, this method can injure the abdominal visceral organs. The open-permanent system model keeps the dialysis catheter and instillation port outside the body. However, this ...

An erratum was issued for:&#160;<a href="https://www.jove.com/t/63689">A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice</a>. The Authors section was updated from:
Saran Lotfollahzadeh1 
Mengwei Zhang1 
Marc Arthur Napoleon1 
Wenqing Yin1 
Josephine Orrick1 
Nagla Elzind1 
Austin Morrissey1 
Isaac E. Sellinger1 
Lauren D. Stern1 
Mostafa Belghasem2 
Jean M. Francis1 
Vipul C. Chitalia1,3,4 
1Renal Section, Department of Medicine, Boston University School of Medicine 
2Department of Biomedical Science, Kaiser Permanente Bernard J. Tyson School of Medicine 
3Veterans Affairs Boston Healthcare System 
4Institute of Medical Engineering and Sciences, Massachusetts Institute of Technology
to:
Saran Lotfollahzadeh1 
Mengwei Zhang1 
Marc Arthur Napoleon1 
Wenqing Yin1 
Josephine Orrick1 
Nagla Elzind1 
Austin Morrissey1 
Isaac E. Sellinger1 
Lauren D. Stern1 
Mostafa Belghasem2 
Jean M. Francis1 
Vipul C. Chitalia1,3,4 
1Renal Section, Department of Medicine, Boston University Aram V. Chobanian &#38; Edward Avedisian School of Medicine 
2Department of Biomedical Science, Kaiser Permanente Bernard J. Tyson School of Medicine 
3Veterans Affairs Boston Healthcare System 
4Institute of Medical Engineering and Sciences, Massachusetts Institute of Technology

An erratum was issued for:&#160;<a href="https://www.jove.com/t/63689">A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice</a>. The Authors section was updated.

Erratum: A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice

End-stage renal disease burden 
Chronic kidney disease (CKD) is a worldwide health problem1. Current estimates suggest that more than 850 million people worldwide have kidney disease. The prevalence of kidney disease almost doubles the number of people with diabetes (422 million) and is more than 20 times the prevalence of cancer (42 million) or HIV/AIDS (36.7 million) patients worldwide2. Approximately one in seven Americans have CKD, and two in 1,000 Americans have ESKD requiring a kidney transplant or dialysis support3. Considering the escalating burden of ESKD worldwide, optimizing dialysis technology is crucial3.
Peritoneal dialysis 
PD is a significantly underutilized modality for the treatment of ESKD in the United States. According to the United States Renal Data System (USRDS), the percentage of prevalent PD patients was only 11% in 20204,5. PD confers several advantages over in-center hemodialysis (HD), including a better quality of life, fewer clinic visits, and a decrease in Medicare expenditures6,7. Additionally, PD is a home-based therapy and is associated with a much lower risk of severe infections such as bacteremia and endocarditis that are often related to hemodialysis catheters. Furthermore, PD can be initiated rapidly with an urgent start protocol, decreasing the need for dialysis initiation with indwelling vascular catheters8. PD is considered the preferred method of dialysis in the pediatric ESKD population9.
Peritoneal impairment induced by peritoneal dialysis 
PD entails introducing PD fluid (dialysate) into the peritoneum, which results in inflammation and remodeling of the peritoneal membrane over time. Peritoneal inflammation triggers fibrosis, culminating in the potential loss of ultrafiltration capabilities of the membrane over time. Preservation of the peritoneal membrane is a significant challenge in PD, and further research is critically important to ensure that best clinical practices are available to practitioners. There are well-established murine models to help further the understanding of pathophysiological mechanisms of peritoneal infection and inflammation, solute, water transport kinetics, and membrane failure; still, technical issues with the catheter often limit these models10.
Analyzing the peritoneal membrane changes 
In ESKD patients, dialysate is traditionally introduced in the peritoneal cavity through a Tenkhoff catheter with a deep and superficial cuff. The patients can potentially experience catheter-related complications, including catheter migration, infusion pain, and poor drainage of the dialysate11,12,13. Two major types of peritoneal catheters have been introduced for humans, coiled or straight, to minimize these complications12. Several modifications, including an extra cuff to the conventional two-cuffed catheters, have been added to the original catheters to prolong PD catheter survival11. The insertion technique varies according to several factors by preventing catheter migration to be added after survival, including the availability of the resources and the level of expertise14.
In contrast, the murine models of peritoneal dialysis have fundamental differences in techniques and purpose compared to human peritoneal catheters. For example, peritoneal catheters in murine models are used primarily to study membrane alterations and are less intended for bidirectional drainage functions. The current technique suffers from potential port dislodgement and catheter migration due to the handling of the animals. In the conventional murine models, the access ports were not fixed to the skin. This aspect created an unstable access port, which in awake animals might get dislodged, resulting in catheter migration. Given the importance of murine models in peritoneal membrane research, it is imperative to create effective surgical techniques to generate reliable models. Therefore,&#160;we set out to optimize the conventional model of PD catheter placement. It is important to note that the catheter itself causes histopathologic alterations in the peritoneal membrane, and, thus, any conclusions regarding the effect of PD solutions in animal studies must be interpreted in the context of the PD catheter as a foreign body15,16,17.
Peritoneal membrane histopathology 
PD failure is mainly related to fibrosis and excess angiogenesis resulting in the loss of an osmolar concentration gradient. In addition, the peritoneal membrane filtration capacity might be affected by peritonitis. In addition, infectious peritonitis is a well-established cause for change in the dialysis modality from peritoneal dialysis to hemodialysis.18.

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			<td>&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; Isoflurane, USP</td>
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			<td>&#160;&#160;&#160;&#160;&#160;&#160; Lipopolysaccharide from E.coli</td>
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			<td>AD-Surgical</td>
			<td>#L-G330R24</td>
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a retrograde implantation approach for peritoneal dialysis catheter placement in mice

Murine models are employed to probe various aspects of peritoneal dialysis (PD), such as peritoneal inflammation and fibrosis. These events drive peritoneal membrane failure in humans, which remains an area of intense investigation due to its profound clinical implications in managing patients with end-stage kidney disease (ESKD). Despite the clinical importance of PD and its related complications, current experimental murine models suffer from key technical challenges that compromise the models&#39; performance. These include PD catheter migration and kinking and usually warrant earlier catheter removal. These limitations also drive the need for a greater number of animals to complete a study. Addressing these drawbacks, this study introduces technical improvements and surgical nuances to prevent commonly observed PD catheter complications in a murine model. Moreover, this modified model is validated by inducing peritoneal inflammation and fibrosis using lipopolysaccharide injections. In essence, this paper describes an improved method to create an experimental model of PD.

All the implanted catheters were functional till the end of the study, and catheter dislodgement or kinking did not complicate any of the implanted catheters. The current, modified technique was further validated with a peritonitis-induced model using LPS. The control mice received 200 &#181;L of daily normal saline injections, while the experimental mice were injected with 200 &#181;L of LPS, as discussed in protocol step 11, for a total of 7 days following catheter implantation.
The peritone...

Watch this Scientific Journal Video about A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice at JoVE.com

A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice

This article describes modifications of a procedure to implant a peritoneal dialysis catheter in a murine model to avoid major technical issues observed with the conventional techniques.

Murine models are employed to probe various aspects of peritoneal dialysis (PD), such as peritoneal inflammation and fibrosis. These events drive ...

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Implantation of a Carotid Cuff for Triggering Shear-stress Induced Atherosclerosis in Mice

It is widely accepted that alterations in vascular shear stress trigger the expression of inflammatory genes in endothelial cells and thereby induce ...

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, affecting millions of individuals worldwide 1-3. The rapid, irregular, and ...

Carotid Artery Infusions for Pharmacokinetic and Pharmacodynamic Analysis of Taxanes in Mice

When proposing the use of a drug, drug combination, or drug delivery into a novel system, one must assess the pharmacokinetics of the drug in the study ...

The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire

The supraclavicular fossa ultrasound view can be useful for central venous catheter (CVC) placement. Venipuncture of the internal jugular veins (IJV) or ...

Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology

A technological platform (MediGuide) has been recently introduced for non-fluoroscopic catheter tracking. In several studies, we have demonstrated that ...

Quantitation of Intra-peritoneal Ovarian Cancer Metastasis

Epithelial ovarian cancer (EOC) is the leading cause of death from gynecologic malignancy in the United States.  Mortality is due to diagnosis of 75% of ...

Surgical Approach for Middle Cerebral Artery Occlusion and Reperfusion Induced Stroke in Mice

Stroke is a leading cause of death worldwide and continues to be one of the major causes of long-term adult disabilities. About 87% of strokes are ...

Implantation of an Isoproterenol Mini-Pump to Induce Heart Failure in Mice

Isoproterenol (ISO), is a non-selective beta-adrenergic agonist, that is used widely to induce cardiac injury in mice. While the acute model mimics ...

Implantation of Combined Telemetric ECG and Blood Pressure Transmitters to Determine Spontaneous Baroreflex Sensitivity in Conscious Mice

Blood pressure (BP) and heart rate (HR) are both controlled by the autonomic nervous system (ANS) and are closely intertwined due to reflex mechanisms. ...

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla

Zygomatic implants (ZIs) are an ideal way to address cases of a severely atrophic edentulous maxilla and maxilla defects because they replace extensive ...