Role of aldose reductase in the peritoneal changes of patients undergoing peritoneal dialysis.
OBJECTIVE
The mesothelium of patients undergoing peritoneal dialysis (PD) is exposed to glucose in dialysate. Glucose metabolites 3-deoxyglucosone and advanced glycation endproducts (AGEs) in the PD fluid induce peritoneal damage. Circulating factors also affect the peritoneum in the uremic model and predialysis patients. Aldose reductase (AR) generates precursors of 3-deoxyglucosone. We have reported AR acceleration in uremic patients. Therefore, AR acceleration might affect the peritoneum. The purpose of this study was to evaluate the AR level in PD patients and to determine the factors that change the peritoneum of these patients.


METHODS
We measured the PD effluent (eff-) concentration of cancer antigen 125 (CA125) as a marker of mesothelial viability in PD patients. Erythrocyte AR, eff-, and plasma (p-) concentrations of 3-deoxyglucosone, AGEs, and malondialdehyde were also studied in 30 PD patients, 18 patients undergoing hemodialysis, and 8 control subjects.


RESULTS
In the PD group, AR, p-3-deoxyglucosone, p-AGEs, and p-malondialdehyde were higher than in the control group. The predictors for eff-CA125 were not only PD duration and eff-3-deoxyglucosone, but also AR.


CONCLUSIONS
AR was upregulated in PD patients. AR acceleration may affect the peritoneum in these patients. Further studies are needed to clarify the role of AR in PD patients.
Hasuike
Yukiko
Y
Department of Nephrology and Dialysis, Hyogo College of Medicine, Hyogo, Japan. cherry39@hyo-med.ac.jp
Moriguchi
Rintarou
R
Hata
Reiko
R
Miyagawa
Kouji
K
Kuragano
Takahiro
T
Aizawa
Masayo
M
Yamamoto
Shigeo
S
Yanase
Kimihiko
K
Izumi
Masaaki
M
Tanimoto
Tsuyoshi
T
Nakanishi
Takeshi
T
D000449:Aldehyde Reductase / Q000096:biosynthesis* / Q000502:physiology; D018394:CA-125 Antigen / Q000032:analysis; D016022:Case-Control Studies; D015314:Dialysis Solutions / Q000009:adverse effects*; D004848:Epithelium / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D005260:Female; D005947:Glucose / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D010530:Peritoneal Dialysis; D010537:Peritoneum / Q000187:drug effects* / Q000503:physiopathology; D015854:Up-Regulation
D018394:CA-125 Antigen; D015314:Dialysis Solutions; D000449:Aldehyde Reductase; D005947:Glucose