title: Exfoliated mesothelial cell and CA-125 in automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) patients.
abstract: OBJECTIVE
  Automated peritoneal dialysis (APD) becomes the first option for peritoneal dialysis, nowadays overtaking continuous ambulatory peritoneal dialysis (CAPD) in many countries. The comparison of peritoneal membrane alteration in CAPD and APD is inconclusive. The authors therefore compared the peritoneal membrane changes in patients undergoing CAPD and APD.
  
  
  METHODS
  In naive end stage renal disease patients, the choice of PD modes (CAPD or APD) was dependent on the patient's decision. Thirty-six CAPD and 25APD patients with a total of 287 patient-months were compared. The peritoneal mass parameter, exfoliated mesothelial cell (MTC) and dialysate CA-125, as well as modified peritoneal equilibrium test (mPET) with 4.25% dextrose solution was simultaneously evaluated at 1 and 6 month follow-up.
  
  
  RESULTS
  Although the peritoneal function (as measured by D/P creatinine, D/D0 glucose, sodium dipping, and dialysate protein loss), adequacy, serum albumin, nutritional status, and residual renal function showed no significant differences between groups at 1 and 6 months, CA-125 but not MTC was higher in APD compared with CAPD at the first month of PD beginning. Due to the single time-point measurement limitation, the authors compared the peritoneal mass parameter differences between 1 and 6 month. During 6-month follow-up, CA-125 decreased 30 +/- 5% vs. 7 +/- 5% and MTC decreased 5 +/- 12% vs. 40 +/- 11% in APD and CAPD, respectively. The higher CA-125 reduction in APD and greater changes of MTC in CAPD suggested that there was less viable mesothelial cell in APD compared with CAPD.
  
  
  CONCLUSIONS
  The authors observed that both APD and CAPD damaged peritoneum. However, there might be higher peritoneal injury in APD patients. The proper randomization study in longer follow-up period is mandatory to confirm this observation.
authors: Division of Nephrology, Department of Medicine, Chulalongkorn University, Bangkok, Thailand. golfnephro@hotmail.com
authors: Talerngsak
authors: T
authors: Kanjanabuch
authors: Nopadol
authors: N
authors: Puttipittayathorn
authors: Asada
authors: A
authors: Leelahavanichkul
authors: Songkiat
authors: S
authors: Lieusuwan
authors: Pisut
authors: P
authors: Katavetin
authors: Nanta
authors: N
authors: Mahatanan
authors: Kanda
authors: K
authors: Sriudom
authors: Thanit
authors: T
authors: Chirananthavat
authors: Nisa
authors: N
authors: Thongbor
authors: Somchai
authors: S
authors: Eiam-Ong
mesh_terms: D018394:CA-125 Antigen / Q000378:metabolism; D004847:Epithelial Cells / Q000166:cytology* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D010537:Peritoneum / Q000166:cytology* / Q000378:metabolism / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D018394:CA-125 Antigen