Acute systemic inflammation is associated with an increase in peritoneal solute transport rate in chronic peritoneal dialysis patients.
BACKGROUND
This study was performed to evaluate the effects of acute systemic inflammation on peritoneal solute transport rate (PSTR) in chronic peritoneal dialysis (CPD) patients.


METHODS
A baseline standard peritoneal equilibration test (PET) was performed on each patient every 6 months, and blood concentration of high-sensitivity C-reactive protein (hs-CRP) was assayed every 2 months in our peritoneal dialysis clinic. Acute systemic inflammation was defined as a greater than 10-fold increase in hs-CRP concentration compared with baseline value, in the absence of peritonitis, and returning to baseline level in 2 months. In patients with acute systemic inflammation, PET and hs-CRP concentration assays were performed during inflammation and after recovery. Ten patients with acute systemic inflammation were enrolled in the inflammation group and 42 other patients served as controls.


RESULTS
There were no significant changes in hs-CRP and dialysate-to-plasma ratio of creatinine (D/Pcreat) in the control group during the study period. In the inflammation group, median hs-CRP levels at baseline, during acute inflammation, and at recovery were 2.3 mg/L (range 0.3 - 4.5 mg/L), 39.2 mg/L (range 15.1 - 117.4 mg/L), and 3.7 mg/L (range 0.9 - 8.9 mg/L), respectively. Median D/Pcreat increased significantly from baseline (0.64; range 0.55 - 0.98) to time of acute inflammation (0.72; range 0.60 - 0.96) (p < 0.05). The D/Pcreat at recovery was 0.67 (range 0.52 - 0.94), which decreased significantly from time of acute inflammation (p < 0.05). There was no correlation between changes in log (hs-CRP) and changes in D/Pcreat.


CONCLUSIONS
We have shown here that acute systemic inflammation is associated with a temporary increase in PSTR in CPD patients.
Kim
Soon Bae
SB
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Chang
Jai Won
JW
Lee
Sang Koo
SK
Park
Jung Sik
JS
D001692:Biological Transport; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010537:Peritoneum / Q000503:physiopathology*; D011446:Prospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000503:physiopathology*
D002097:C-Reactive Protein