Impact of systemic and local peritoneal inflammation on peritoneal solute transport rate in new peritoneal dialysis patients: a 1-year prospective study.

Abstract

BACKGROUND:

The association between peritoneal solute transport rates (PSTRs) and inflammatory markers in patients on peritoneal dialysis (PD) is still under investigation. We aimed to elucidate their relationship during the first year on PD.

METHODS:

We performed a prospective observational study with 187 incident PD patients who were treated with either biocompatible solution (BCS) or conventional solution (CS). Peritoneal dialysate effluent (PDE) and blood samples for the markers and the calculation of mass transfer area coefficient of creatinine (MTAC) were performed at 1, 6 and 12 months after commencing PD.

RESULTS:

Of the 187 enrolled patients, 110 completed a 1-year study protocol. All PDE markers [interleukin-6 (IL-6), transforming growth factor-beta (TGF-beta), TGF-beta-induced gene-h3 (beta ig-h3), vascular endothelial growth factor (VEGF)] except CA125 increased over time, whereas PSTRs, high-sensitivity C-reactive protein (hs-CRP) and serum IL-6 levels did not change. Serum albumin and log PDE appearance rates (ARs) of IL-6, TGF-beta and CA125 predicted MTAC. The Delta value (12-month minus 1-month) of PDE AR of IL-6 was correlated with those of all other PDE markers. Both 12-month IL-6 and Delta IL-6 ARs in PDE were highest in the upper Delta MTAC tertile. PSTRs in the CS group, unlike BCS, had a tendency to increase over time, demonstrating a time-by-group interaction. Solution type and MTAC were not associated with patient and technique survival.

CONCLUSIONS:

The change in PSTR during the first year of PD is related to PDE IL-6 AR, which may represent intraperitoneal inflammation; however, there does not seem to be a close association between PSTR and the degree of systemic inflammation.

• Authors: Ji-Hyung Cho, In-Kyong Hur, Chan-Duck Kim, Sun-Hee Park, Hye-Myung Ryu, Ju-Min Yook, Ji-Young Choi, Hee-Jung Choi, Hyuk-Joon Choi, Jong-Won Park, Jun-Young Do, Yong-Lim Kim
• Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 25 Issue 6 Pg. 1964-73 (Jun 2010) ISSN: 1460-2385 [Electronic] England
• PMID: 20100731 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• CA-125 Antigen
• Cytokines
• Dialysis Solutions
• IL6 protein, human
• Inflammation Mediators
• Interleukin-6
• MUC16 protein, human
• Membrane Proteins
• Transforming Growth Factor beta
• Creatinine

Topics

• Adult
• Aged
• Biological Transport, Active
• Biomarkers (analysis, blood)
• CA-125 Antigen (analysis, blood)
• Creatinine (analysis, blood)
• Cytokines (analysis, blood)
• Dialysis Solutions
• Female
• Humans
• Inflammation (physiopathology)
• Inflammation Mediators (analysis, blood)
• Interleukin-6 (analysis, blood)
• Kaplan-Meier Estimate
• Kidney Failure, Chronic (physiopathology, therapy)
• Male
• Membrane Proteins (analysis, blood)
• Middle Aged
• Peritoneal Dialysis (adverse effects)
• Peritoneum (physiopathology)
• Peritonitis (physiopathology)
• Permeability
• Prospective Studies
• Transforming Growth Factor beta (analysis, blood)