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
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DOI：
10.1159/000099332
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发表时间：
2007-01-01
影响因子：
4.2
通讯作者：
Krediet, Raymond T.
中科院分区：
文献类型：
--
作者：
Rodrigues, Anabela S.;Martins, Margarida;Krediet, Raymond T.
背景/目的：基线快速溶质转运的决定因素尚不清楚。我们前瞻性地研究了腹膜溶质转运与炎症、血管生成和膜状态标志物的关系，重点是快速转运蛋白。研究方法：使用3.86%葡萄糖透析液，对71例腹膜透析患者进行基线和年度腹膜平衡试验评估。研究了残余肾功能和炎症标志物，包括全身和腹膜内白细胞介素-6（IL-6）、流出物癌抗原125（CA-125）和血管内皮生长因子（VEGF）出现率（AR）。通过混合线性模型研究透析液与血浆肌酐比值（D/P肌酐比值）的时间过程及其与生物标志物的关系。结果如下：事件快/快平均转运者具有相似的年龄、糖尿病患病率、血清和流出液IL-6水平，但CA-125和VEGF AR水平显著高于慢/慢平均转运组; D/P肌酐比值与全身IL-6无关，但与流出液CA-125 AR相关（r = 0.45，p < 0.0001）和VEGF AR（r = 0.52，p < 0.0001）。D/P肌酐比值呈U形下降（p = 0.02）。腹膜内IL-6是D/P肌酐比值时间进程的显著和阳性决定因素（p < 0.0001）。流出液CA-125随腹膜透析时间的延长而降低（p = 0.013）。结论：基线腹膜快速转运与全身性炎症无关，但与腹膜局部产生的能够介导暂时性高通透性的物质有关。在随访期间，D/P肌酐比值呈U形变化。这与流出液IL-6和部分VEGF相关。CA-125在整个随访期间下降。版权所有（c）2007 S. Karger AG，巴塞尔。
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. Copyright (c) 2007 S. Karger AG, Basel.