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
2011 Impact Factor: 2.097
2011 SCImago Journal Rankings: 0.091
ReferencesReferences in Scopus
DC Field
Value
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
2011 Impact Factor: 2.097
2011 SCImago Journal Rankings: 0.091
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
Author Affiliations
  1. Prince of Wales Hospital Hong Kong