Document Detail


Impact of systemic and local peritoneal inflammation on peritoneal solute transport rate in new peritoneal dialysis patients: a 1-year prospective study.
MedLine Citation:
PMID:  20100731     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-25
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  25     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-26     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1964-73     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biological Markers / analysis,  blood
Biological Transport, Active
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-Meiers 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
Chemical
Reg. No./Substance:
0/Biological Markers; 0/CA-125 Antigen; 0/Cytokines; 0/Dialysis Solutions; 0/IL6 protein, human; 0/Inflammation Mediators; 0/Interleukin-6; 0/MUC16 protein, human; 0/Membrane Proteins; 0/Transforming Growth Factor beta; 60-27-5/Creatinine

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