title: Evaluation of peritoneal transport and membrane status in peritoneal dialysis: focus on incident fast transporters.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Nephrology, Hospital Geral de Santo António, University of Porto, Porto, Portugal. ar.cbs@mail.telepac.pt
authors.forename: Anabela S
authors.initials: AS
authors.lastname: Rodrigues
authors.forename: Margarida
authors.initials: M
authors.lastname: Martins
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Korevaar
authors.forename: Sandra
authors.initials: S
authors.lastname: Silva
authors.forename: José C
authors.initials: JC
authors.lastname: Oliveira
authors.forename: Antonio
authors.initials: A
authors.lastname: Cabrita
authors.forename: João
authors.initials: J
authors.lastname: Castro e Melo
authors.forename: Raymond T
authors.initials: RT
authors.lastname: Krediet
mesh_terms: D001202:Ascitic Fluid / Q000378:metabolism*; D001693:Biological Transport, Active / Q000502:physiology; D015415:Biomarkers / Q000378:metabolism; D018394:CA-125 Antigen / Q000378:metabolism; D015314:Dialysis Solutions / Q000493:pharmacokinetics*; D005500:Follow-Up Studies; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy; D008567:Membranes, Artificial; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000295:instrumentation*; D010537:Peritoneum / Q000187:drug effects / Q000378:metabolism*; D010538:Peritonitis / Q000209:etiology / Q000378:metabolism; D011379:Prognosis; D011446:Prospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D015415:Biomarkers; D018394:CA-125 Antigen; D015314:Dialysis Solutions; D015850:Interleukin-6; D008567:Membranes, Artificial; D042461:Vascular Endothelial Growth Factor A