Peritoneal fast transport in incident peritoneal dialysis patients is not consistently associated with systemic inflammation

Rodrigues, Anabela; Almeida, Manuela; Fonseca, Isabel; Martins, Margarida Isabel Barros Coelho; Carvalho, Maria João; Silva, Fernanda; Correia, Carlos; Santos, Mário; Cabrita, António

doi:10.1093/ndt/gfi245

Cited by 43 publications

(33 citation statements)

References 26 publications

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“…Of note, the study on IL-6 polymorphisms was done in a population of fast transport patients that was older and had more cardiovascular disease and lower plasma albumin concentrations than the population of the present study. As we also previously reported [11], the baseline fast transport status, as measured by D/P creatinine ratio, was not an independent risk factor for patient survival in our population, but comorbidity and increased serum levels of IL-6 were.…”

Section: Discussionsupporting

confidence: 64%

“…However, these studies usually focused on prevalent PD fast transporters with scarce knowledge on the characteristics and determinants of this status in early-stage PD. Some investigators [10,11,12] were also unable to document the association between peritoneal transport and systemic inflammation consistently, while other studies [13,14,15,16,17,18] did not indicate baseline peritoneal transport status as an independent predictor of mortality. Therefore, a causal link between systemic inflammation and baseline peritoneal transport remains controversial.…”

Section: Introductionmentioning

confidence: 99%

“…We hypothesize that the short-term peritoneal transport profile may have determinants different from those that induce long-term changes. An initial fast transport status may be related mainly to intraperitoneal processes, such as the reactivity of a larger mesothelial cell mass, able to produce increased levels of intraperitoneal vasoactive substances, among which the vascular endothelial growth factor (VEGF) [19,20,21,22], without detrimental impact on patient survival [11]. …”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Peritoneal Transport and Membrane Status in Peritoneal Dialysis: Focus on Incident Fast Transporters

Rodrigues

Martins

Korevaar³

et al. 2007

Am J Nephrol

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Background/Aim: The determinants of baseline fast solute transport are still unclear. We prospectively investigated the relationship of peritoneal solute transport with markers of inflammation, angiogenesis, and membrane status, with a focus on fast transporters. Methods: Seventy-one incident peritoneal dialysis patients were assessed with baseline and annual peritoneal equilibration tests, using a 3.86% glucose dialysis solution. Residual renal function and markers of inflammation, including systemic and intraperitoneal interleukin-6 (IL-6), effluent cancer antigen 125 (CA-125), and vascular endothelial growth factor (VEGF) appearance rates (ARs), were investigated. The time course of the dialysate-to-plasma ratio of creatinine (D/P creatinine ratio) and its relationship with the biomarkers were investigated by a mixed linear model. Results: Incident fast/fast average transporters had a similar age, diabetes prevalence, and serum and effluent IL-6 levels, but significantly higher levels of CA-125 and VEGF ARs than the slow/slow average group; the D/P creatinine ratio was not correlated with systemic IL-6, but was correlated with effluent CA-125 AR (r = 0.45, p < 0.0001) and VEGF AR (r = 0.52, p < 0.0001). The D/P creatinine ratio decreased with a U-shaped profile (p = 0.02). Intraperitoneal IL-6 was the significant and positive determinant of the time course of the D/P creatinine ratio (p < 0.0001). Effluent CA-125 decreased with time on peritoneal dialysis (p = 0.013). Conclusions: Baseline peritoneal fast transport was not associated with systemic inflammation, but was related to peritoneal locally produced substances able to mediate transitory hyperpermeability. The D/P creatinine ratio changed during the follow-up period with a U-shaped profile. This was associated with effluent IL-6 and partly with VEGF. CA-125 decreased throughout the follow-up period.

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Section: Discussionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of Peritoneal Transport and Membrane Status in Peritoneal Dialysis: Focus on Incident Fast Transporters

Rodrigues

Martins

Korevaar³

et al. 2007

Am J Nephrol

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“…However, PET ultrafiltration volumes were inversely associated with serum sodium and albumin concentrations, suggesting that inflammation and protein malnutrition may affect ultrafiltration volumes (31).…”

Section: Discussionmentioning

confidence: 96%

Hydration Status Does Not Influence Peritoneal Equilibration Test Ultrafiltration Volumes

Davenport

Willicombe

2009

Clinical Journal of the American Society of Nephrology

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Background and objectives: The peritoneal equilibration test (PET) was developed some 25 yr ago and has been used to help prescribe peritoneal dialysis. However, PET is affected by several factors, including diabetes and inflammation. It was speculated that extracellular fluid overload would increase PET ultrafiltration volumes, and therefore the usefulness of the PET in routine clinical practice was audited.Design, setting, participants, & measurements: Data from 211 consecutive patients attending a university teaching hospital for a standard PET who had multifrequency bioimpedance performance were analyzed to determine which factors affected net PET ultrafiltration volumes.Results: Net PET ultrafiltration volume was independent of gender, age, diabetes, residual renal function, peritoneal dialysis prescriptions (modes and dialysates), extracellular fluid volume, or C-reactive protein (CRP). There was an inverse regression with serum albumin and sodium on multiple logistical regression analysis (F ‫؍‬ 13.4, P < 0.001 and F ‫؍‬ 10.1, P ‫؍‬ 0.001, respectively) and a positive regression with 24-h net peritoneal ultrafiltration volumes (F ‫؍‬ 15.5, P < 0.001). As expected, there was a strong correlation with net sodium losses (r ‫؍‬ 0.99, P < 0001).Conclusions: It was found that PET test ultrafiltration volume in routine clinical practice was not affected by CRP, hyperglycemia, or extracellular fluid volume overload. Ultrafiltration volumes were increased in those patients with reduced serum sodium and albumin, most likely because of inflammation and protein malnutrition.

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“…Moreover, the correlation between UFF/ transport status and high glucose usage would mean anyone with high/fast transport status would be likely to be "EPS-prone." The literature would suggest that (10,11). However, defining these "suspicions" can be difficult and often relies on senior clinical judgment.…”

mentioning

confidence: 99%

Is there an end in Sight for Encapsulating Peritoneal Sclerosis?

Paudel

Fan

2014

Perit Dial Int

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Peritoneal fast transport in incident peritoneal dialysis patients is not consistently associated with systemic inflammation

Abstract: Initial fast transport was not associated with systemic inflammation and atherosclerosis. In a population with preserved RRF and absence of baseline serious co-morbidity, it was not predictive of worse prognosis. Other determinants of early peritoneal fast transport deserve investigation.

Cited by 43 publications

References 26 publications

Evaluation of Peritoneal Transport and Membrane Status in Peritoneal Dialysis: Focus on Incident Fast Transporters

Evaluation of Peritoneal Transport and Membrane Status in Peritoneal Dialysis: Focus on Incident Fast Transporters

Hydration Status Does Not Influence Peritoneal Equilibration Test Ultrafiltration Volumes

Is there an end in Sight for Encapsulating Peritoneal Sclerosis?

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