Impact of systemic and local peritoneal inflammation on peritoneal solute transport rate in new peritoneal dialysis patients: a 1-year prospective study.
BACKGROUND
The association between peritoneal solute transport rates (PSTRs) and inflammatory markers in patients on peritoneal dialysis (PD) is still under investigation. We aimed to elucidate their relationship during the first year on PD.


METHODS
We performed a prospective observational study with 187 incident PD patients who were treated with either biocompatible solution (BCS) or conventional solution (CS). Peritoneal dialysate effluent (PDE) and blood samples for the markers and the calculation of mass transfer area coefficient of creatinine (MTAC) were performed at 1, 6 and 12 months after commencing PD.


RESULTS
Of the 187 enrolled patients, 110 completed a 1-year study protocol. All PDE markers [interleukin-6 (IL-6), transforming growth factor-beta (TGF-beta), TGF-beta-induced gene-h3 (beta ig-h3), vascular endothelial growth factor (VEGF)] except CA125 increased over time, whereas PSTRs, high-sensitivity C-reactive protein (hs-CRP) and serum IL-6 levels did not change. Serum albumin and log PDE appearance rates (ARs) of IL-6, TGF-beta and CA125 predicted MTAC. The Delta value (12-month minus 1-month) of PDE AR of IL-6 was correlated with those of all other PDE markers. Both 12-month IL-6 and Delta IL-6 ARs in PDE were highest in the upper Delta MTAC tertile. PSTRs in the CS group, unlike BCS, had a tendency to increase over time, demonstrating a time-by-group interaction. Solution type and MTAC were not associated with patient and technique survival.


CONCLUSIONS
The change in PSTR during the first year of PD is related to PDE IL-6 AR, which may represent intraperitoneal inflammation; however, there does not seem to be a close association between PSTR and the degree of systemic inflammation.
Cho
Ji-Hyung
JH
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
Hur
In-Kyong
IK
Kim
Chan-Duck
CD
Park
Sun-Hee
SH
Ryu
Hye-Myung
HM
Yook
Ju-Min
JM
Choi
Ji-Young
JY
Choi
Hee-Jung
HJ
Choi
Hyuk-Joon
HJ
Park
Jong-Won
JW
Do
Jun-Young
JY
Kim
Yong-Lim
YL
D000328:Adult; D000368:Aged; D001693:Biological Transport, Active; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D018394:CA-125 Antigen / Q000032:analysis / Q000097:blood; D003404:Creatinine / Q000032:analysis / Q000097:blood; D016207:Cytokines / Q000032:analysis / Q000097:blood; D015314:Dialysis Solutions; D005260:Female; D006801:Humans; D007249:Inflammation / Q000503:physiopathology*; D018836:Inflammation Mediators / Q000032:analysis / Q000097:blood; D015850:Interleukin-6 / Q000032:analysis / Q000097:blood; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008565:Membrane Proteins / Q000032:analysis / Q000097:blood; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010537:Peritoneum / Q000503:physiopathology*; D010538:Peritonitis / Q000503:physiopathology*; D010539:Permeability; D011446:Prospective Studies; D016212:Transforming Growth Factor beta / Q000032:analysis / Q000097:blood
D015415:Biomarkers; D018394:CA-125 Antigen; D016207:Cytokines; D015314:Dialysis Solutions; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; C451759:MUC16 protein, human; D008565:Membrane Proteins; D016212:Transforming Growth Factor beta; D003404:Creatinine