Plasma and Dialysate Immunoglobulin G in Continuous Ambulatory Peritoneal Dialysis Patients: A Multicenter Study

Abstract

Peritoneal dialysate immunoglobin (Ig)G concentrations were measured in 120 continuous ambulatory peritoneal diaysis (CAPD) patients evaluated at four dialysis centers in different countries to assess the normal range for dialysate IgG and to investigate the relationships of this protein levels with peritoneal episodes, For 65 of these patients, plasma IgG levels were determined, and IgG clearances were calculated. The mean dialysate concentration of IgG was 6.9 ± 4.2 mg/dl, and there was no difference between men and women or between patients who had or had not previously undergone hemodialysis. Dialysate IgG concentrations were significantly related to residual renal creatinine clearance and negatively correlated with dialysate volume, plasma albumin and total protein. There were no significant correlations between IgG levels in the dialysate and age, protein losses in the dialysate, time on CAPD or time from the last peritonitis episode. Plasma and dialysate IgG were unrelated to the incidence of peritonitis, statistical analysis being performed with different methods. These results suggest that IgG levels in the dialysate or plasma are not a major factor in the prevention of CAPD peritonitis.

Humoral immunity and frequency of peritonitis in chronic peritoneal dialysis patients

“…The median concentrations of IgG in peritoneal fluid in adults were 4.59 mg/dl (range 0.92-27.4) and 12.15 mg/dl (range 5.01-26.2) at the beginning and at the end of the study, respectively. These results are similar to those of other studies [5,17]. In addition, the median concentration of peritoneal dialysis fluid was higher in adults than in pediatric patients.…”

“…In our study, no correlation was found between hypogammaglobulinemia and the frequency of peritonitis in either children or adults, which supports previous studies [4,15,17,18]. The frequency of peritonitis in children was lower than in adult patients who had not had hypogamma-88 globulinemia.…”

“…However, other investigators have found no relationship between episodes of peritonitis and peritoneal dialysate IgG levels [17,18]. In our study, no correlation was found between the frequency of peritonitis and the levels of IgG and IgG subgroups in peritoneal dialysis fluid from either pediatric or adult patients.…”

Sürekli Ayaktan Periton Diyaliz Hastalarında Peritonit ve Serum-Diyalizat İmmünglobulin-G Subgrup Düzeyleri İlişkisi

“…Peritondaki IgG düşük olduğunda, opsonik aktivitenin de düşük olması beklenirken, peritondaki IgG konsantrasyonu düşük olmaksızın opsonik aktivitenin azalabileceği de gösterilmiştir (12). IgG konsantrasyonu ile peritonit sıklığı arasında negatif korelasyon saptanan çalışmalar (13,14) varlığının yanısıra ilişki olmadığını bildiren çalışmalar da vardır (15). SAPD'de plazma ve diyalizat IgG düzeylerinin değerlendirildiği multisentrik bir çalışmada; diyalizatta ortalama IgG düzeyi 6,9±4,2 mg/dl olarak saptanmıştır ve diyalizat IgG düzeyi rezidüel renal klirens ile yakın ilişkili bulunmuştur.…”

“…Diyalizat volümü, plazma albumini ve total protein ile negatif korelasyon saptanmıştır. Peritonit sayısı ile serum ve diyalizat IgG düzeyi arasında ilişki saptanmamıştır (15). Diğer bir çalışmada da 36 SAPD hastasında serum ve diyalizat IgG, C3, albumin düzeyleri değerlendirilmiş ve peritonit riski ile korelasyon saptanamamıştır (16).…”