title: Inflammation, neoangiogenesis and fibrosis in peritoneal dialysis.
abstract: Peritoneal dialysis (PD) is a form of renal replacement therapy used in patients with end stage renal disease (ESRD). It is based on using the peritoneum as a semipermeable membrane through which ultrafiltration (UF) and diffusion occur. Despite several benefits, PD has long-term complications, including inflammation, neoangiogenesis and fibrosis. Several inflammatory molecules can be found in the dialysate of PD patients including: interleukins (IL), tumor necrosis factor α (TNF-α) and C-reactive protein (CRP). Angiogenesis results in increased effective surface area exchange. Consequently, the glucose-driven osmotic pressure of the peritoneal dialysis fluid (PDF) is significantly reduced leading to UF failure (UFF). Several factors are implicated in the development of peritoneal fibrosis (PF) in PD patients. The most important factor is the conventional bio-incompatible PD solution, which contains high concentration of glucose and glucose degradation products (GDP). Although there are several studies elucidating the mechanisms leading to UFF in PD patients, more studies needed to be developed in this area and more research is required to find mechanisms to delay or to minimize the occurrence of many deleterious changes in peritoneal membrane (PM) during PD.
authors: Health Sciences Center, Federal University of São João Del-Rei, Divinópolis-MG, Brazil.
authors: Silvia Maia Alves
authors: SM
authors: de Lima
authors: Alba
authors: A
authors: Otoni
authors: Adriano de Paula
authors: Ade P
authors: Sabino
authors: Luci Maria Sant'Ana
authors: LM
authors: Dusse
authors: Karina Braga
authors: KB
authors: Gomes
authors: Sérgio Wyton Lima
authors: SW
authors: Pinto
authors: Maria Aparecida Silva
authors: MA
authors: Marinho
authors: Danyelle Romana Alves
authors: DR
authors: Rios
mesh_terms: D001692:Biological Transport; D016207:Cytokines / Q000276:immunology / Q000378:metabolism; D015314:Dialysis Solutions / Q000009:adverse effects*; D005947:Glucose / Q000009:adverse effects*; D017583:Hemodiafiltration; D006801:Humans; D007249:Inflammation / Q000276:immunology / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D009389:Neovascularization, Pathologic / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D009997:Osmotic Pressure; D010530:Peritoneal Dialysis; D056627:Peritoneal Fibrosis / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D010537:Peritoneum / Q000098:blood supply / Q000473:pathology
chemical_list: D016207:Cytokines; D015314:Dialysis Solutions; D005947:Glucose