Proof-of-principle study to detect metabolic changes in peritoneal dialysis effluent in patients who develop encapsulating peritoneal sclerosis.

Abstract

BACKGROUND:

Prolonged peritoneal dialysis (PD) therapy can result in the development of encapsulating peritoneal sclerosis (EPS), characterized by extensive sclerosis of the peritoneum with bowel adhesions often causing obstruction.

METHODS:

As a proof-of-principle study, holistic profiling of endogenous metabolites has been applied in a prospective collection of PD effluent collected in multiple UK renal centres over 6 years in order to investigate metabolic differences in PD effluent between PD therapy patients who later developed clinically defined EPS (n = 11) and controls, who were matched for PD vintage, age and gender (n = 11).

RESULTS:

'Fit-for-purpose' analytical methods employing gas chromatography-mass spectrometry (MS), direct injection MS and quality control samples were developed and validated. These methods were applied in a proof-of-principle study to define metabolic differences in PD effluent related to subsequent development of EPS. Changes in amino acids, amines and derivatives, short-chain fatty acids and derivatives and sugars were observed prior to EPS developing, and changes in the metabolomic profiles could be detected.

CONCLUSION:

There is potential for applying metabolic profiles to identify patients at risk of developing EPS although long-term prospective studies with larger patient cohorts are required.

• Authors: Warwick B Dunn, Angela Summers, Marie Brown, Royston Goodacre, Mark Lambie, Tim Johnson, Martin Wilkie, Simon Davies, Nick Topley, Paul Brenchley
• Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 27 Issue 6 Pg. 2502-10 (Jun 2012) ISSN: 1460-2385 [Electronic] England
• PMID: 22294777 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Case-Control Studies
• Cross-Sectional Studies
• Follow-Up Studies
• Gas Chromatography-Mass Spectrometry
• Humans
• In Vitro Techniques
• Kidney Failure, Chronic
• Metabolomics
• Peritoneal Dialysis, Continuous Ambulatory (adverse effects)
• Peritoneum (metabolism, pathology)
• Peritonitis (diagnosis, etiology, metabolism)
• Prognosis
• Prospective Studies
• Retrospective Studies
• Sclerosis (diagnosis, etiology, metabolism)