Peritoneal Solute Transport and Inflammation
Peritoneal Solute Transport and Inflammation
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DOI：
10.1053/j.ajkd.2014.06.030
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发表时间：
2014-12-01
影响因子：
13.2
通讯作者：
Davies, Simon J.
中科院分区：
文献类型：
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作者：
Davies, Simon J.
小溶质穿过腹膜的速度，称为腹膜溶质转运速率（PSTR），是单个膜性能的关键指标。PSTR可以通过使用4小时透析液与血浆肌酐的比值轻松量化，尽管该比值仅近似于膜的扩散特性，但在其与患者存活率和纵向膜功能变化的关系方面已得到充分的临床验证。这导致了腹膜透析方式使用和透析处方的变化。PSTR的一个重要决定因素是腹膜内炎症，如局部白细胞介素6产生所例示，其在很大程度上独立于全身性炎症及其与共病病症和死亡率增加的关系。没有强有力的证据支持这样的论点，即在治疗开始时，一些高PSTR个体的腹膜在性质上是不同的;相反，它代表了一个部分由遗传因素决定的谱。临床和实验证据都支持这样的观点，即持续的腹膜内炎症，检测为持续高或增加的PSTR，可能使膜易于进行性纤维化。(C)2014年，美国国家肾脏基金会（National Kidney Foundation，Inc.）
The speed with which small solutes cross the peritoneal membrane, termed peritoneal solute transport rate (PSTR), is a key measure of individual membrane performance. PSTR can be quantified easily by using the 4-hour dialysate to plasma creatinine ratio, which, although only an approximation to the diffusive characteristics of the membrane, has been well validated clinically in terms of its relationship to patient survival and changes in longitudinal membrane function. This has led to changes in peritoneal dialysis modality use and dialysis prescription. An important determinant of PSTR is intraperitoneal inflammation, as exemplified by local interleukin 6 production, which is largely independent of systemic inflammation and its relationship to comorbid conditions and increased mortality. There is no strong evidence to support the contention that the peritoneal membrane in some individuals with high PSTR is qualitatively different at the start of treatment; rather, it represents a spectrum that is determined in part by genetic factors. Both clinical and experimental evidence support the view that persistent intraperitoneal inflammation, detected as a continuously high or increasing PSTR, may predispose the membrane to progressive fibrosis. (C) 2014 by the National Kidney Foundation, Inc.