title: Peritoneal macrophage infiltration is correlated with baseline peritoneal solute transport rate in peritoneal dialysis patients.
abstract: BACKGROUND
  High baseline peritoneal solute transport rate is reportedly associated with reduced patient and technique survival in continuous peritoneal dialysis (PD) patients. However, the determinants of baseline peritoneal solute transport rate remain uncertain. The aim of this study was to investigate the relationship between peritoneal local inflammation, angiogenesis and systemic inflammation and baseline peritoneal permeability.
  
  
  METHODS
  Peritoneal biopsy specimens from 42 pre-dialysis uraemic patients and 11 control individuals were investigated. Immunohistochemistry for CD68-positive macrophages, chymase- and tryptase-positive mast cells, interleukin-6 (IL-6)-positive cells, CD3-positive T cells, CD20-positive B cells, neutrophils and CD31- and pathologische anatomie Leiden-endothelium (PAL-E)-positive blood vessels in the peritoneum was performed. Baseline dialysate-to-plasma ratio for creatinine (D/P Cr) was determined within 6 months of PD induction. Clinical and laboratory parameters were measured at the time of peritoneal biopsy. Factors associated with peritoneal permeability were assessed by multiple linear regression analysis.
  
  
  RESULTS
  Pre-dialysis uraemic peritoneum showed infiltration by CD68-positive macrophages, and mast cells, as compared with controls. Baseline D/P Cr was correlated with density of CD68-positive macrophages (P < 0.001), IL-6-positive cells (P < 0.001), CD31-positive (P < 0.05) and PAL-E-positive blood vessels (P < 0.05) and serum albumin (P < 0.05). However, baseline peritoneal permeability was not correlated with infiltration by mast cells, B cells, T cells, neutrophils, serum C-reactive protein or other clinical factors. On multiple linear regression analysis, the number of CD68-positive macrophages in peritoneum was an independent predictor for baseline peritoneal permeability (P = 0.009).
  
  
  CONCLUSIONS
  Peritoneal macrophage infiltration is predominant in uraemic patients and is an important factor in predicting baseline peritoneal permeability.
authors.affiliation: Department of Nephrology and Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Akiho
authors.initials: A
authors.lastname: Sawai
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Ito
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizuno
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Susumu
authors.initials: S
authors.lastname: Toda
authors.forename: Isao
authors.initials: I
authors.lastname: Ito
authors.forename: Ryohei
authors.initials: R
authors.lastname: Hattori
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Matsukawa
authors.forename: Momokazu
authors.initials: M
authors.lastname: Gotoh
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Takei
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yuzawa
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsuo
mesh_terms: D001692:Biological Transport; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D015314:Dialysis Solutions / Q000493:pharmacokinetics*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007124:Immunoenzyme Techniques; D007249:Inflammation / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000150:complications*; D007677:Kidney Function Tests; D017737:Macrophages, Peritoneal / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014018:Tissue Distribution
chemical_list: D015415:Biomarkers; D015314:Dialysis Solutions