Journal Article

Impact of systemic and local peritoneal inflammation on peritoneal solute transport rate in new peritoneal dialysis patients: a 1-year prospective study

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 and Yong-Lim Kim

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 25, issue 6, pages 1964-1973
Published in print June 2010 | ISSN: 0931-0509
Published online January 2010 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfp767
Impact of systemic and local peritoneal inflammation on peritoneal solute transport rate in new peritoneal dialysis patients: a 1-year prospective study

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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-β (TGF-β), TGF-β-induced gene-h3 (βig-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-β and CA125 predicted MTAC. The Δ 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 ΔIL-6 ARs in PDE were highest in the upper ΔMTAC 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.

Keywords: inflammation; peritoneal dialysis; peritoneal solute transport rate

Journal Article.  5386 words.  Illustrated.

Subjects: Nephrology

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