Peritoneal changes in patients on long-term peritoneal dialysis

Krediet, Raymond T.; Struijk, Dirk G.

doi:10.1038/nrneph.2013.99

Cited by 115 publications

(117 citation statements)

References 137 publications

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“…35,NO. 3 FIRST PERITONITIS ALTERS THE NATURAL COURSE OF PERITONEAL TRANSPORT temporary effect of peritonitis on small solute transport and net ultrafiltration, which recovered after the acute phase (8,9).…”

Section: Pdimentioning

confidence: 99%

The First Peritonitis Episode Alters the Natural Course of Peritoneal Membrane Characteristics in Peritoneal Dialysis Patients

et al. 2015

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♦ Objective: Little or no evidence is available on the impact of the first peritonitis episode on peritoneal transport characteristics. The objective of this study was to investigate the importance of the very first peritonitis episode and distinguish its effect from the natural course by comparison of peritoneal transport before and after infection. ♦ Participants: We analyzed prospectively collected data from 541 incident peritoneal dialysis (PD) patients, aged > 18 years, between 1990 and 2010. Standard Peritoneal Permeability Analyses (SPA) within the year before and within the year after (but not within 30 days) the first peritonitis were compared. In a control group without peritonitis, SPAs within the first and second year of PD were compared. ♦ Main outcome measurements: SPA data included the mass transfer area coefficient of creatinine, glucose absorption and peritoneal clearances of β-2-microglobulin (b2m), albumin, IgG and α-2-macroglobulin (a2m). From these clearances, the restriction coefficient to macromolecules (RC) was calculated. Also, parameters of fluid transport were determined: transcapillary ultrafiltration rate (TCUFR), lymphatic absorption (ELAR), and free water transport. Crude and adjusted linear mixed models were used to compare the slopes of peritoneal transport parameters in the peritonitis group to the control group. Adjustments were made for age, sex and diabetes. ♦ Results: Of 541 patients, 367 experienced a first peritonitis episode within a median time of 12 months after the start of PD. Of these, 92 peritonitis episodes were preceded and followed by a SPA within one year. Forty-five patients without peritonitis were included in the control group. Logistic reasons (peritonitis group: 48% vs control group: 83%) and switch to hemodialysis (peritonitis group: 22% vs control group: 3%) were the main causes of missing SPA data post-peritonitis and post-control. When comparing the slopes of peritoneal transport parameters in the peritonitis group and the control group, a first peritonitis episode was associated with faster small solute transport (glucose absorption, p = 0.03) and a concomitant lower TCUFR (p = 0.03). In addition, a discreet decrease in macromolecular

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Section: Pdimentioning

confidence: 99%

The First Peritonitis Episode Alters the Natural Course of Peritoneal Membrane Characteristics in Peritoneal Dialysis Patients

et al. 2015

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“…A total of 45 male rats were divided into five groups with nine rats each: NC, which was only receiving sham operation without other treatment; NS, which was receiving daily infusion of 20 mL of 0.9% physiological saline for 6 weeks, and permanent PD catheters were inserted; HG, which was receiving daily infusion of 20 mL of 4.25% glucose dialysis solution for 6 weeks, and permanent PD catheters were inserted; L-RAPA, which was receiving daily intragastric administration of 1 mgÁkg À1 rapamycin (Sigma Corp.) at later time points (weeks 4-6) for total 3 weeks, based on a PD model group; H-RAPA, which was receiving daily intragastric administration of 2 mgÁkg À1 rapamycin (weeks [4][5][6] for total 3 weeks, based on a PD model group. The volume and concentration of PD solution and rapamycin were based on previous studies [22,65].…”

Section: Animal Model Of Pdmentioning

confidence: 99%

“…However, long-term exposure of the peritoneal membrane to nonbiocompatible peritoneal dialysis fluid, including high concentrations of glucose and lactate, glucose degradation products (GDPs), and low pH [1], can result in functional and structural abnormalities of peritoneum, eventually leading to the PD failure [2][3][4]. High glucose (HG) has been shown to cause fibrosis by upregulating the expression of transforming growth factor-b1 (TGF-b1) [5], vascular endothelial growth factor (VEGF) [6], Abbreviations ECM, extracellular matrix; EMT, epithelial-mesenchymal transition; EPS, encapsulating peritoneal sclerosis; FKBP12, FK506-binding protein-12; GDPs, glucose degradation products; HG, high glucose; mTORC, mTOR complex; mTOR, mammalian target of rapamycin; PD, peritoneal dialysis; PI3K, phosphoinositide 3-kinase; PMC, peritoneal mesothelial cell; TBST, tris-buffered saline tween-20; TGF-b1, transforming growth factor-b1; VEGF, vascular endothelial growth factor; a-SMA, a-smooth muscle actin.…”

Section: Introductionmentioning

confidence: 99%

Rapamycin inhibits epithelial‐to‐mesenchymal transition of peritoneal mesothelium cells through regulation of Rho GTPases

Xiang

Xie

et al. 2016

The FEBS Journal

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Epithelial–mesenchymal transition (EMT) of peritoneal mesothelial cells (PMCs) is a key process of peritoneal fibrosis. Rapamycin has been previously shown to inhibit EMT of PMCs and prevent peritoneal fibrosis. In this study, we investigated the undefined molecular mechanisms by which rapamycin inhibits EMT of PMCs. To define the protective effect of rapamycin, we initially used a rat PD model which was daily infused with 20 mL of 4.25% high glucose (HG) dialysis solution for 6 weeks to induce fibrosis. The HG rats showed decreased ultrafiltration volume and obvious fibroproliferative response, with markedly increased peritoneal thickness and higher expression of α‐smooth muscle actin (α‐SMA) and transforming growth factor‐β1. Rapamycin significantly ameliorated those pathological changes. Next, we treated rat PMCs with HG to induce EMT and/or rapamycin for indicated time. Rapamycin significantly inhibited HG‐induced EMT, which manifests as increased expression of α‐SMA, fibronectin, and collagen I, decreased expression of E‐cadherin, and increased mobility. HG increased the phosphorylation of PI3K, Akt, and mTOR. Importantly, rapamycin inhibits the RhoA, Rac1, and Cdc42 activated by HG. Moreover, rapamycin repaired the pattern of F‐actin distribution induced by HG, reducing the formation of stress fiber, focal adhesion, lamellipodia, and filopodia. Thus, rapamycin shows an obvious protective effect on HG‐induced EMT, by inhibiting the activation of Rho GTPases (RhoA, Rac1, and Cdc42).

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“…Atualmente Hong Kong e México, com taxa de utilização da DP em torno de 70 %, são os países em que a modalidade está mais difundida (3) (18,19).…”

Section: Diálise Peritoneal -Epidemiologiaunclassified

“…As áreas fibróticas contém colágeno I, colágeno IV e miofibroblastos (18). Estudos experimentais têm auxiliado o entendimento dos mecanismos envolvidos nessas alterações e, notadamente, a origem dos miofibroblastos e as vias de sinalização do Transforming Growth Factor (TGF-β) têm sido foco de diversos trabalhos.…”

Section: Fibrose Peritonealunclassified

Análise do efeito do ácido valpróico no modelo experimental de fibrose peritoneal em ratos

Costalonga¹

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Peritoneal changes in patients on long-term peritoneal dialysis

Cited by 115 publications

References 137 publications

The First Peritonitis Episode Alters the Natural Course of Peritoneal Membrane Characteristics in Peritoneal Dialysis Patients

The First Peritonitis Episode Alters the Natural Course of Peritoneal Membrane Characteristics in Peritoneal Dialysis Patients

Rapamycin inhibits epithelial‐to‐mesenchymal transition of peritoneal mesothelium cells through regulation of Rho GTPases

Análise do efeito do ácido valpróico no modelo experimental de fibrose peritoneal em ratos

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