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Article: Longitudinal study of peritoneal membrane function in continuous ambulatory peritoneal dialysis: Relationship with peritonitis and fibrosing factors
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TitleLongitudinal study of peritoneal membrane function in continuous ambulatory peritoneal dialysis: Relationship with peritonitis and fibrosing factors
 
AuthorsWong, TYH1
Szeto, CC1
Lai, KB1
Lam, CWK1
Lai, KN1
Li, PKT1
 
KeywordsPeritonitis
TGFβ
 
Issue Date2001
 
PublisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.com
 
CitationPeritoneal Dialysis International, 2001, v. 20 n. 6, p. 679-685 [How to Cite?]
 
Abstract◆ Background: The peritoneal equilibration test (PET) is a useful assessment of peritoneal function in continuous ambulatory peritoneal dialysis (CAPD) patients. However, the natural course of longitudinal change in peritoneal transport is not well defined. ◆ Patients: We studied 105 unselected CAPD patients. Average age at enrollment was 50.7 ± 11.3 years. ◆ Methods: A PET was performed at enrollment. Peritoneal transport was expressed as dialysate-to-plasma creatinine ratio at 4 hours (D/P). Fibrosing factors and mesothelial cell markers, including TGFβ, epidermal growth factor (EGF), platelet-derived growth factor (PDGF), hyaluronan, and cancer antigen 125 (CA125), were measured in overnight peritoneal dialysate effluent (PDE). Patients were followed for two years. Peritonitis episodes were recorded. Severe peritonitis was defined as an episode that required catheter removal or antibiotic therapy for more than 3 weeks. After two years, 75 patients were still alive and on CAPD. ◆ Results: The PET was repeated in 64 patients, of whom 35 were male and 9 had diabetes. The change in D/P over two years was represented as ΔD/P. No significant change in peritoneal transport was seen after two years (D/P: 0.56 ± 0.12 vs 0.55 ± 0.13). A centripetal pattern of change in D/P was observed. The ΔD/P had normal distribution and was inversely correlated with D/P at baseline (r = -0.427, p < 0.005). Both results suggest a regression-to-mean phenomenon. The ΔD/P had no significant correlation with the total number of peritonitis episodes (Spearman r = 0.052, p = 0.74), but after severe peritonitis, affected patients had higher ΔD/P than patients who experienced no severe infection (0.040 ± 0.136 vs -0.032 ± 0.120, p < 0.05). For patients with no episodes of severe peritonitis (n = 47), ΔD/P was weakly correlated with baseline TGFβ level (r = -0.506, p < 0.01). No correlation was seen between the levels of other fibrosing factors and change in peritoneal transport. ◆ Conclusions: Our findings suggest that the centripetal change of peritoneal transport probably reflects a regression-to-mean phenomenon. Peritoneal transport increases after severe peritonitis. The role of TGFβ levels in PDE with regard to longitudinal change in peritoneal transport requires further study.
 
ISSN0896-8608
2013 Impact Factor: 2.199
2013 SCImago Journal Rankings: 1.189
 
ISI Accession Number IDWOS:000166707100016
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorWong, TYH
 
dc.contributor.authorSzeto, CC
 
dc.contributor.authorLai, KB
 
dc.contributor.authorLam, CWK
 
dc.contributor.authorLai, KN
 
dc.contributor.authorLi, PKT
 
dc.date.accessioned2010-09-06T07:23:44Z
 
dc.date.available2010-09-06T07:23:44Z
 
dc.date.issued2001
 
dc.description.abstract◆ Background: The peritoneal equilibration test (PET) is a useful assessment of peritoneal function in continuous ambulatory peritoneal dialysis (CAPD) patients. However, the natural course of longitudinal change in peritoneal transport is not well defined. ◆ Patients: We studied 105 unselected CAPD patients. Average age at enrollment was 50.7 ± 11.3 years. ◆ Methods: A PET was performed at enrollment. Peritoneal transport was expressed as dialysate-to-plasma creatinine ratio at 4 hours (D/P). Fibrosing factors and mesothelial cell markers, including TGFβ, epidermal growth factor (EGF), platelet-derived growth factor (PDGF), hyaluronan, and cancer antigen 125 (CA125), were measured in overnight peritoneal dialysate effluent (PDE). Patients were followed for two years. Peritonitis episodes were recorded. Severe peritonitis was defined as an episode that required catheter removal or antibiotic therapy for more than 3 weeks. After two years, 75 patients were still alive and on CAPD. ◆ Results: The PET was repeated in 64 patients, of whom 35 were male and 9 had diabetes. The change in D/P over two years was represented as ΔD/P. No significant change in peritoneal transport was seen after two years (D/P: 0.56 ± 0.12 vs 0.55 ± 0.13). A centripetal pattern of change in D/P was observed. The ΔD/P had normal distribution and was inversely correlated with D/P at baseline (r = -0.427, p < 0.005). Both results suggest a regression-to-mean phenomenon. The ΔD/P had no significant correlation with the total number of peritonitis episodes (Spearman r = 0.052, p = 0.74), but after severe peritonitis, affected patients had higher ΔD/P than patients who experienced no severe infection (0.040 ± 0.136 vs -0.032 ± 0.120, p < 0.05). For patients with no episodes of severe peritonitis (n = 47), ΔD/P was weakly correlated with baseline TGFβ level (r = -0.506, p < 0.01). No correlation was seen between the levels of other fibrosing factors and change in peritoneal transport. ◆ Conclusions: Our findings suggest that the centripetal change of peritoneal transport probably reflects a regression-to-mean phenomenon. Peritoneal transport increases after severe peritonitis. The role of TGFβ levels in PDE with regard to longitudinal change in peritoneal transport requires further study.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationPeritoneal Dialysis International, 2001, v. 20 n. 6, p. 679-685 [How to Cite?]
 
dc.identifier.epage685
 
dc.identifier.hkuros59917
 
dc.identifier.isiWOS:000166707100016
 
dc.identifier.issn0896-8608
2013 Impact Factor: 2.199
2013 SCImago Journal Rankings: 1.189
 
dc.identifier.issue6
 
dc.identifier.openurl
 
dc.identifier.pmid11216559
 
dc.identifier.scopuseid_2-s2.0-0035110521
 
dc.identifier.spage679
 
dc.identifier.urihttp://hdl.handle.net/10722/76675
 
dc.identifier.volume20
 
dc.languageeng
 
dc.publisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.com
 
dc.publisher.placeCanada
 
dc.relation.ispartofPeritoneal Dialysis International
 
dc.relation.referencesReferences in Scopus
 
dc.subjectPeritonitis
 
dc.subjectTGFβ
 
dc.titleLongitudinal study of peritoneal membrane function in continuous ambulatory peritoneal dialysis: Relationship with peritonitis and fibrosing factors
 
dc.typeArticle
 
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<contributor.author>Li, PKT</contributor.author>
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Author Affiliations
  1. Prince of Wales Hospital Hong Kong