Do interleukin-6, hyaluronan, soluble intercellular adhesion molecule-1 and cancer antigen 125 in dialysate predict changes in peritoneal function? A 1-year follow-up study.
OBJECTIVE
Diminishing ultrafiltration and dialysis adequacy may limit the long-term use of peritoneal dialysis (PD). Inflammation may play a role in changes in peritoneal function. This study was designed to evaluate alterations in peritoneal function and soluble factors in dialysate during a 1-year follow-up period.


METHODS
A personal dialysis capacity test was performed at the start of the study and after 6 and 12 months in 20 patients in order to determine dialysis adequacy and membrane characteristics. Dialysate was collected during the test days for analyses of interleukin-6 (IL-6), soluble intercellular adhesion molecule-1, hyaluronan and cancer antigen 125 (CA125).


RESULTS
There were no significant changes in dialysis adequacy or membrane characteristics during the 1-year follow-up period. The appearance rate of IL-6 in dialysate increased significantly (419.8+/-63.3 at the start, 784.1+/-136.4 after 6 months and 1149.3+/-252.2 ng/24 h after 12 months; p=0.006) during follow-up. Furthermore, the appearance rate of CA125 increased throughout the study in patients using icodextrin, but decreased slightly in patients using only conventional dialysis solutions.


CONCLUSIONS
There were no major changes in dialysis adequacy or membrane characteristics during the follow-up period, but increased IL-6 in dialysate may reflect peritoneal inflammation, which may lead to long-term alterations in the peritoneal membrane. Icodextrin may have a preventive effect on the longevity of the peritoneal membrane.
Martikainen
Terhi
T
Department of Medicine, Division of Nephrology, Helsinki University Central Hospital, Helsinki, Finland.
Ekstrand
Agneta
A
Honkanen
Eero
E
Teppo
Anna-Maija
AM
Grönhagen-Riska
Carola
C
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D018394:CA-125 Antigen / Q000032:analysis*; D015314:Dialysis Solutions / Q000737:chemistry*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000032:analysis*; D018799:Intercellular Adhesion Molecule-1 / Q000032:analysis*; D015850:Interleukin-6 / Q000032:analysis*; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000502:physiology*; D010538:Peritonitis / Q000209:etiology / Q000517:prevention & control; D011379:Prognosis; D006435:Renal Dialysis; D012189:Retrospective Studies; D013997:Time Factors
D015415:Biomarkers; D018394:CA-125 Antigen; D015314:Dialysis Solutions; D015850:Interleukin-6; D018799:Intercellular Adhesion Molecule-1; D006820:Hyaluronic Acid