Acute Systemic Inflammation is Associated with an Increase in Peritoneal Solute Transport Rate in Chronic Peritoneal Dialysis Patients

2004 ◽  
Vol 24 (6) ◽  
pp. 597-600 ◽  
Author(s):  
Soon Bae Kim ◽  
Jai Won Chang ◽  
Sang Koo Lee ◽  
Jung Sik Park
Keyword(s):  
Peritoneal Dialysis ◽  
Solute Transport ◽  
Systemic Inflammation ◽  
Acute Inflammation ◽  
Transport Rate ◽  
Temporary Increase ◽  
Chronic Peritoneal Dialysis ◽  
Hs Crp ◽  
Inflammation Group ◽  
Peritoneal Solute Transport Rate

Background This study was performed to evaluate the effects of acute systemic inflammation on peritoneal solute transport rate (PSTR) in chronic peritoneal dialysis (CPD) patients. Methods A baseline standard peritoneal equilibration test (PET) was performed on each patient every 6 months, and blood concentration of high-sensitivity C-reactive protein (hs-CRP) was assayed every 2 months in our peritoneal dialysis clinic. Acute systemic inflammation was defined as a greater than 10-fold increase in hs-CRP concentration compared with baseline value, in the absence of peritonitis, and returning to baseline level in 2 months. In patients with acute systemic inflammation, PET and hs-CRP concentration assays were performed during inflammation and after recovery. Ten patients with acute systemic inflammation were enrolled in the inflammation group and 42 other patients served as controls. Results There were no significant changes in hs-CRP and dialysate-to-plasma ratio of creatinine (D/Pcreat) in the control group during the study period. In the inflammation group, median hs-CRP levels at baseline, during acute inflammation, and at recovery were 2.3 mg/L (range 0.3 – 4.5 mg/L), 39.2 mg/L (range 15.1 – 117.4 mg/L), and 3.7 mg/L (range 0.9 – 8.9 mg/L), respectively. Median D/Pcreat increased significantly from baseline (0.64; range 0.55 – 0.98) to time of acute inflammation (0.72; range 0.60 – 0.96) ( p < 0.05). The D/Pcreat at recovery was 0.67 (range 0.52 – 0.94), which decreased significantly from time of acute inflammation ( p < 0.05). There was no correlation between changes in log (hs-CRP) and changes in D/Pcreat. Conclusion We have shown here that acute systemic inflammation is associated with a temporary increase in PSTR in CPD patients.

scholarly journals Dialysate interleukin-6 predicts increasing peritoneal solute transport rate in incident peritoneal dialysis patients

2014 ◽  
Vol 15 (1) ◽  
Author(s):  
Yeoungjee Cho ◽  
David W Johnson ◽  
David A Vesey ◽  
Carmel M Hawley ◽  
Elaine M Pascoe ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Solute Transport ◽  
Interleukin 6 ◽  
Transport Rate ◽  
Dialysis Patients ◽  
Peritoneal Solute Transport Rate

scholarly journals Osteopontin levels in the drained dialysate reflect the peritoneal solute transport rate

2020 ◽  
Author(s):  
Jianzhong Li ◽  
Jingjing Lan ◽  
Qing Qiao ◽  
Lei Shen ◽  
Guoyuan Lu
Keyword(s):  
Peritoneal Dialysis ◽  
Solute Transport ◽  
Transforming Growth Factor ◽  
Transport Rate ◽  
Low Grade ◽  
Peritoneal Fibrosis ◽  
Independent Predictive Factor ◽  
Membrane Injury ◽  
Ultrafiltration Failure ◽  
Peritoneal Solute Transport Rate

Abstract Background and objectives: Long-term peritoneal dialysis (PD) is accompanied by low-grade intraperitoneal inflammation, may eventually lead to peritoneal membrane injury with high solute transport rate and ultrafiltration failure. Osteopontin(OPN) is highly expressed with the pro-inflammatory cytokines stimulation in many cell types, and evolves in the process of tissue fibrosis. This study aimed to investigate the potential of OPN as a new indicator of peritoneal injury. Methods: We analyzed a total of 125 PD patients with end-stage renal disease, including 16 patients with continuous ambulatory PD(CAPD)-related peritonitis and 109 patients without peritonitis in a single renal center. The OPN levels in the overnight peritoneal effluents or in serum were analyzed using ELISA. In HMrSV5 cells, The OPN and fibronectin(FN) protein expression were identified using western blot analysis. Results: The OPN levels in overnight drained dialysate were significantly correlated with D/P Cr (P < 0.0001, R =0.54) and D/D0 glucose (P < 0.0001 R=-0.39). Logistical regression analysis showed that the OPN levels in peritoneal effluents was an independent predictive factor for the increased peritoneal solute transport rate (PSTR) (p < 0.001). The area under the receiver operating characteristic (ROC) curve of the OPN-PSTR model for identifying PSTR was 0.88, with 95% confidence interval (CI):0.81-0.95. The OPN was more abundant in peritoneal effluents of the CAPD-related peritonitis group compared with the patients without peritonitis (18.64±13.04 vs. 2.23±1.63 ng/ml, p<0.001). In the in vitro experiment, lipopolysaccharides(LPS) increased the OPN expression in HMrSV5 cells, whereas downregulation of OPN suppressed FN induction with transforming growth factor-β1(TGF-β1)stimulation. Conclusions: The OPN levels in drained dialysate were independently correlated with peritoneal transport status in accordance with the PET results. OPN was highly expressed in effluents in patients with CAPD-related peritonitis. Peritoneal mesothelial cells displayed a high expression of OPN under inflammatory stimuli and OPN was likely to be implicated in the progression of peritoneal fibrosis. Thus, OPN may be a useful indicator of peritoneal injury in patients with PD. Keywords: peritoneal dialysis, osteopontin, peritoneal injury, peritoneal solute transport rate

Effects of Interleukin-6 T15A Single Nucleotide Polymorphism on Baseline Peritoneal Solute Transport Rate in Incident Peritoneal Dialysis Patients

2009 ◽  
Vol 29 (1) ◽  
pp. 81-88 ◽  
Author(s):  
Young-Hwan Hwang ◽  
Min-Jeong Son ◽  
Jaeseok Yang ◽  
Kiwon Kim ◽  
Wookyung Chung ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Solute Transport ◽  
Interleukin 6 ◽  
Residual Renal Function ◽  
Transport Rate ◽  
Strong Positive Correlation ◽  
Nucleotide Polymorphisms ◽  
Necrosis Factor Alpha ◽  
Single Nucleotide ◽  
Peritoneal Solute Transport Rate

Objective To study the genetic effects of various inflammatory cytokines on peritoneal solute transport rate (PSTR) in incident Korean peritoneal dialysis (PD) patients. Design Case-control association study. Methods 132 patients with baseline peritoneal equilibration test within 1 – 3 months after starting PD were enrolled. We analyzed the influence of single nucleotide polymorphisms (SNPs) of interleukin-6 (IL-6; -572G/C, T15A), tumor necrosis factor-alpha (TNF-α; -1031C/T, -863C/A, -308G/A), and IL-10 (-1082A/G, -592A/C) on baseline PSTR. Clinical parameters such as age, gender, presence of diabetes mellitus, comorbidity, C-reactive protein, and residual renal function were also included as covariates. Results The T15A SNP of IL-6 (rs13306435) was associated with PSTR. Patients with TA genotype ( n = 18) had significantly lower D4/P creatinine (0.65 ± 0.087 vs 0.73 ± 0.110, p = 0.0046) and higher D4/D0 glucose (0.39 ± 0.174 vs 0.31 ± 0.119, p = 0.027) than patients with TT genotype ( n = 114). The log value of the dialysate appearance rate of IL-6 had a strong positive correlation with D4/P creatinine ( r2 = 0.1294, p < 0.0001) and was significantly lower in the TA genotype than the TT genotype (201.7 ± 14.42 vs 116.8 ± 88.91 pg/minute, p = 0.0358). By multiple logistic regression, TA genotype was negatively associated with a higher PSTR (high or high average; odds ratio 0.18; 95% confidence interval 0.048 – 0.666). Conclusions In incident Korean PD patients, T15A polymorphism of IL-6 is associated with dialysate IL-6 concentration and baseline PSTR.

scholarly journals Associations between dialysate interleukin-6 and Tie-2 and peritoneal solute transport rate and outcomes for patients undergoing peritoneal dialysis: A prospective cohort study

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Ying Hang ◽  
Hao Yan ◽  
He Zhang ◽  
Zhenyuan Li ◽  
Wei Fang
Keyword(s):  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Solute Transport ◽  
Prospective Cohort Study ◽  
Interleukin 6 ◽  
Prospective Cohort ◽  
Transport Rate ◽  
All Cause Mortality ◽  
Peritoneal Solute Transport Rate

Objectives: We designed this prospective observational study to clarify the associations between dialysate IL-6, a marker of ongoing peritoneal inflammation, Tie2, an important factor in angiogenesis in the peritoneum, and a high peritoneal solute transport rate (PSTR) in patients undergoing peritoneal dialysis (PD) and to investigate their outcome predictive roles. Methods: A total of 60 stable continuous ambulatory peritoneal dialysis (CAPD) patients from a single center in China were analyzed in this prospective study. We measured dialysate levels of IL-6 and Tie-2 using ELISAs. Our primary study endpoint was all-cause mortality with 10 years’ follow-up. Results: For the evaluation of PSTR, we used the Dialysis/Plasma creatinine (D/Pcr) ratio. We subdivided the patients into two groups for statistical evaluation: low and low average D/Pcr (<0.64; L/A), and high and high average D/Pcr (≥0.65; H/A) transporters. The mean levels of dialysates IL-6 (21.71 ± 8.88 pg/mL) and Tie-2 (1.23 ± 0.43 ng/mL) were significantly higher in the H/A (high and high average, group than those in the L/A group (13.94 ± 5.43 pg/mL, p<0.001 and 0.95 ± 0.43 ng/mL, p=0.019; respectively). Moreover, IL-6 and Tie-2 were positively correlated with D/Pcr (r=0.366, p=0.004 and r=0.402, p=0.001; respectively). Both dialysates IL-6 and Tie-2 were independent determinants of a high peritoneal solute transport rate. After follow-up for 42.65±18.08 months, 30 patients (50.0%) had died. An increased D/Pcr increased the risk of all-cause mortality in patients with CAPD (p=0.018), but the dialysates IL-6 and Tie2 were not independent predictors of all-cause mortality (p>0.05). Conclusion: Our results suggest that patients undergoing CAPD have a high peritoneal solute transport status with local peritoneal inflammation and angiogenesis. Increased D/Pcr is a relative risk factor for mortality and technique failure in patients undergoing CAPD. doi: https://doi.org/10.12669/pjms.37.4.4328 How to cite this:Hang Y, Yan H, Zhang H, Li Z, Fang W. Associations between dialysate interleukin-6 and Tie-2 and peritoneal solute transport rate and outcomes for patients undergoing peritoneal dialysis: A prospective cohort study. Pak J Med Sci. 2021;37(4):---------.  doi: https://doi.org/10.12669/pjms.37.4.4328 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Combination of Crystalloid (Glucose) and Colloid (Icodextrin) Osmotic Agents Markedly Enhances Peritoneal Fluid and Solute Transport during the Long PD Dwell

2007 ◽  
Vol 27 (3) ◽  
pp. 267-276 ◽  
Author(s):  
Philippe Freida ◽  
Magda Galach ◽  
Jose C. Divino Filho ◽  
Andrzej Werynski ◽  
Bengt Lindholm
Keyword(s):  
Peritoneal Dialysis ◽  
Solute Transport ◽  
Residual Renal Function ◽  
Transport Rate ◽  
Dialysis Patients ◽  
Fluid Removal ◽  
Sodium Removal ◽  
Ultra Filtration ◽  
Osmotic Agents ◽  
Peritoneal Solute Transport Rate

Background Fluid and sodium removal is often inadequate in peritoneal dialysis patients with high peritoneal solute transport rate, especially when residual renal function is declining. Method We studied the effects of using simultaneous crystalloid (glucose) and colloid (icodextrin) osmotic agents on the peritoneal transport of fluid, sodium, and other solutes during 15-hour single-dwell exchanges using 3.86% glucose, 7.5% icodextrin, and a combination fluid with 2.61% glucose and 6.8% icodextrin in 7 prevalent peritoneal dialysis patients with fast peritoneal solute transport rate. Results The combination fluid enhanced net ultrafiltration (mean 990 mL) and sodium removal (mean 158 mmol) compared with 7.5% icodextrin (mean net ultrafiltration 462 mL, mean net sodium removal 49 mmol). In contrast, the 3.86% glucose-based solution yielded negligible ultra-filtration (mean -85 mL) and sodium removal (mean 16 mmol). The combination solution resulted in significantly improved urea (+41%) and creatinine (+26%) clearances compared with 7.5% icodextrin. Conclusion A solution containing both crystalloid (glucose 2.61%) and colloid (icodextrin 6.8%) osmotic agents enhanced fluid removal by twofold and sodium removal by threefold compared with 7.5% icodextrin solution during a dwell of 15 hours, indicating that such a combination solution could represent a new treatment option for anuric peritoneal dialysis patients with high peritoneal solute transport rate.

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