title: Role of aldose reductase in the peritoneal changes of patients undergoing peritoneal dialysis.
abstract: 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.
authors.affiliation: Department of Nephrology and Dialysis, Hyogo College of Medicine, Hyogo, Japan. cherry39@hyo-med.ac.jp
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Hasuike
authors.forename: Rintarou
authors.initials: R
authors.lastname: Moriguchi
authors.forename: Reiko
authors.initials: R
authors.lastname: Hata
authors.forename: Kouji
authors.initials: K
authors.lastname: Miyagawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kuragano
authors.forename: Masayo
authors.initials: M
authors.lastname: Aizawa
authors.forename: Shigeo
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Yanase
authors.forename: Masaaki
authors.initials: M
authors.lastname: Izumi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tanimoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakanishi
mesh_terms: 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
chemical_list: D018394:CA-125 Antigen; D015314:Dialysis Solutions; D000449:Aldehyde Reductase; D005947:Glucose