Quantitative assessment of the peritoneal vessel density and vasculopathy in CAPD patients.
BACKGROUND
Peritoneal sclerosis (PS) complicates continuous ambulatory peritoneal dialysis (CAPD). Exploring the peritoneal vascular changes, which are characteristic histological findings in long-term PD, may give new insight into the basic pathological process leading to PS. We present a quantitative analysis of peritoneal vascular density as well as vasculopathy grades in relation to PD duration.


METHODS
Peritoneal samples from 56 stable CAPD patients were analysed, and cases with membrane failure were excluded. Patients were classified into four groups according to CAPD duration in years: group A (n = 12), 0 year; group B (n = 11), 1-5 years; group C (n = 17), 5-9 years; and group D (n = 16), >9 years. The total density, of microvessels (capillaries, post-capillary venules and venules) and the density of each vasculopathy grade (0 = intact, 1 = mild, 2 = moderate and 3 = severe) in the compact zone were calculated (numbers/mm(2)) in each sample and the percentage ratio of each grade in relation to the total vessel density was also determined.


RESULTS
There was no significant difference in the total vessel density (P-value = 0.64). In the grade of vasculopathy (density and percentage ratio), there were significant differences among groups, with grade 0 highest in group A, grade 1 highest in group C and grade 3 highest in group D.


CONCLUSIONS
The results of this study indicate that vascular density does not increase, at least in stable uncomplicated PD, and that intact vessels decrease with time on PD, while the severe grades of vasculopathy predominate especially on a long-term basis.
Department of Kidney and Hypertension, The Jikei University School of Medicine, 3-19-18 Nishi shinbashi, Tokyo 105-8471, Japan. alimsherif@yahoo.com
Ali M
AM
Sherif
Masaaki
M
Nakayama
Yukio
Y
Maruyama
Hiraku
H
Yoshida
Hiroyasu
H
Yamamoto
Keitaro
K
Yokoyama
Makio
M
Kawakami
D000328:Adult; D000368:Aged; D001808:Blood Vessels / Q000254:growth & development / Q000473:pathology; D005260:Female; D006652:Histological Techniques; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008833:Microcirculation / Q000473:pathology; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010537:Peritoneum / Q000098:blood supply*; D012598:Sclerosis / Q000209:etiology; D014652:Vascular Diseases / Q000209:etiology* / Q000473:pathology