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Article: Longitudinal study of peritoneal membrane function in continuous ambulatory peritoneal dialysis: Relationship with peritonitis and fibrosing factors

TitleLongitudinal study of peritoneal membrane function in continuous ambulatory peritoneal dialysis: Relationship with peritonitis and fibrosing factors
Authors
KeywordsPeritonitis
TGFβ
Issue Date2001
PublisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.com
Citation
Peritoneal 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.
Persistent Identifierhttp://hdl.handle.net/10722/76675
ISSN
2013 Impact Factor: 2.199
2013 SCImago Journal Rankings: 1.189
ISI Accession Number ID
References

 

Author Affiliations
  1. Prince of Wales Hospital Hong Kong
DC FieldValueLanguage
dc.contributor.authorWong, TYHen_HK
dc.contributor.authorSzeto, CCen_HK
dc.contributor.authorLai, KBen_HK
dc.contributor.authorLam, CWKen_HK
dc.contributor.authorLai, KNen_HK
dc.contributor.authorLi, PKTen_HK
dc.date.accessioned2010-09-06T07:23:44Z-
dc.date.available2010-09-06T07:23:44Z-
dc.date.issued2001en_HK
dc.identifier.citationPeritoneal Dialysis International, 2001, v. 20 n. 6, p. 679-685en_HK
dc.identifier.issn0896-8608en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76675-
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.en_HK
dc.languageengen_HK
dc.publisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.comen_HK
dc.relation.ispartofPeritoneal Dialysis Internationalen_HK
dc.subjectPeritonitisen_HK
dc.subjectTGFβen_HK
dc.titleLongitudinal study of peritoneal membrane function in continuous ambulatory peritoneal dialysis: Relationship with peritonitis and fibrosing factorsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0896-8608&volume=20&issue=6&spage=679&epage=685&date=2000&atitle=Longitudinal+study+of+peritoneal+membrane+function+in+continuous+ambulatory+peritoneal+dialysis:+relationship+with+peritonitis+and+fibrosing+factorsen_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid11216559en_HK
dc.identifier.scopuseid_2-s2.0-0035110521en_HK
dc.identifier.hkuros59917en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035110521&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume20en_HK
dc.identifier.issue6en_HK
dc.identifier.spage679en_HK
dc.identifier.epage685en_HK
dc.identifier.isiWOS:000166707100016-
dc.publisher.placeCanadaen_HK
dc.identifier.scopusauthoridWong, TYH=7403531489en_HK
dc.identifier.scopusauthoridSzeto, CC=35495407200en_HK
dc.identifier.scopusauthoridLai, KB=7402135525en_HK
dc.identifier.scopusauthoridLam, CWK=8531362100en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.scopusauthoridLi, PKT=25928016800en_HK

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