Peritoneal effluent MMP-2 and PAI-1 in encapsulating peritoneal sclerosis.

Abstract

BACKGROUND:

Recently, the use of effluent matrix metalloproteinase 2 (MMP-2) and plasminogen activator inhibitor 1 (PAI-1) as potential biomarkers of peritoneal fibrosis has been demonstrated during longitudinal follow-up of incident peritoneal dialysis (PD) patients. This study focuses on effluent MMP-2 and PAI-1 as early diagnostic markers in the preceding years of patients who develop encapsulating peritoneal sclerosis (EPS).

STUDY DESIGN:

Diagnostic test study.

SETTINGS & PARTICIPANTS:

PD patients who developed EPS were compared with controls using a 1:3 case-control design with a minimum PD duration of 57 months.

INDEX TESTS:

Dialysate appearance rates of MMP-2 and PAI-1.

REFERENCE TEST:

EPS cases identified by 2 experienced nephrologists and a radiologist based on predefined criteria.

RESULTS:

11 patients developed EPS within our center. The time course of MMP-2 appearance rates, studied by means of a linear repeated-measures model 4 years prior to the diagnosis of EPS, showed no difference between long-term controls and patients with EPS. In contrast, higher PAI-1 appearance rates were found in patients with EPS compared with controls (P=0.01). At a lag time of 1 year prior to EPS diagnosis, time-specific receiver operating characteristic curve analyses indicated a discriminative ability for PAI-1 appearance rate of 0.77 (95% CI, 0.63-0.91). A discriminative capacity was absent for those of MMP-2.

LIMITATIONS:

Low event rate of EPS prevented independent validation in this single-center study.

CONCLUSIONS:

Elevated levels of PAI-1 appearance rates are present in patients who develop EPS, pointing to progressive peritoneal fibrosis and sclerosis. The PAI-1 appearance rate has fair discriminative capacity from 3 years prior to EPS diagnosis. Therefore, effluent PAI-1 may aid in monitoring peritoneal fibrosis and serve as a biomarker for EPS.

• Authors: Deirisa Lopes Barreto, Dirk G Struijk, Raymond T Krediet
• Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 65 Issue 5 Pg. 748-53 (May 2015) ISSN: 1523-6838 [Electronic] United States
• PMID: 25530106 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• Dialysis Solutions
• Plasminogen Activator Inhibitor 1
• Matrix Metalloproteinase 2

Topics

• Adult
• Aged
• Biomarkers (analysis)
• Dialysis Solutions (chemistry)
• Female
• Humans
• Male
• Matrix Metalloproteinase 2 (analysis)
• Middle Aged
• Peritoneal Dialysis (adverse effects)
• Peritoneal Fibrosis (diagnosis, etiology)
• Plasminogen Activator Inhibitor 1 (analysis)
• Young Adult