Document Detail


Epithelial-to-mesenchymal transition of mesothelial cells is an early event during peritoneal dialysis and is associated with high peritoneal transport.
MedLine Citation:
PMID:  18379544     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ultrafiltration (UF) failure is a consequence of long-term peritoneal dialysis (PD). Fibrosis, angiogenesis, and vasculopathy are causes of this functional disorder after 3-8 years on PD. Epithelial-to-mesenchymal transition (EMT) of mesothelial cell (MC) is a key process leading to peritoneal fibrosis with functional deterioration. Our purpose was to study the peritoneal anatomical changes during the first months on PD, and to correlate them with peritoneal functional parameters. We studied 35 stable PD patients for up to 2 years on PD, with a mean age of 45.3+/-14.5 years. Seventy-four percent of patients presented loss of the mesothelial layer, 46% fibrosis (>150 microm) and 17% in situ evidence of EMT (submesothelial cytokeratin staining), which increased over time. All patients with EMT showed myofibroblasts, while only 36% of patients without EMT had myofibroblasts. The number of peritoneal vessels did not vary when we compared different times on PD. Vasculopathy was present in 17% of the samples. Functional studies were used to define the peritoneal transport status. Patients in the highest quartile of mass transfer area coefficient of creatinine (Cr-MTAC) (>11.8 ml min(-1)) showed significantly higher EMT prevalence (P=0.016) but similar number of peritoneal vessels. In the multivariate analysis, the highest quartile of Cr-MTAC remained as an independent factor predicting the presence of EMT (odds ratio 12.4; confidence interval: 1.6-92; P=0.013) after adjusting for fibrosis (P=0.018). We concluded that, during the first 2 PD years, EMT of MCs is a frequent morphological change in the peritoneal membrane. High solute transport status is associated with its presence but not with increased number of peritoneal vessels.
Authors:
G Del Peso; J A Jiménez-Heffernan; M A Bajo; L S Aroeira; A Aguilera; A Fernández-Perpén; A Cirugeda; M J Castro; R de Gracia; R Sánchez-Villanueva; J A Sánchez-Tomero; M López-Cabrera; R Selgas
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Kidney international. Supplement     Volume:  -     ISSN:  0098-6577     ISO Abbreviation:  Kidney Int. Suppl.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-01     Completed Date:  2008-05-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7508622     Medline TA:  Kidney Int Suppl     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S26-33     Citation Subset:  IM    
Affiliation:
Servicio de Nefrología y Unidad de Investigación, Hospital Universitario La Paz, Red Renal de Investigación Cooperativa , Madrid, Spain. gpeso.hulp@salud.madrid.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biological Transport / physiology
Biopsy
Cell Differentiation / physiology*
Creatinine / metabolism
Epithelial Cells / pathology*
Epithelium / pathology*
Female
Fibrosis
Humans
Male
Middle Aged
Multivariate Analysis
Peritoneal Dialysis*
Peritoneum / blood supply,  metabolism*,  pathology*
Phenotype
Regression Analysis
Time Factors
Chemical
Reg. No./Substance:
60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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