title: Inflammatory factors for hypoalbuminemia in Japanese peritoneal dialysis patients.
abstract: OBJECTIVE
  Hypoalbuminaemia is a common complication of peritoneal dialysis (PD), and the leakage of albumin through peritoneal membrane may be a principal reason for hypoalbuminaemia. However, the relationship between peritoneal inflammation, peritoneal transport properties and hypoalbuminaemia has not been fully elucidated.
  
  
  METHODS
  A cross-sectional study was performed on 76 Japanese PD patients who had been using a low-glucose PD solution and icodextrin. Systemic inflammatory markers of C-reactive protein (CRP) and serum interleukin-6 (IL-6), peritoneal effluent markers of dialysate IL-6 and CA125, the dialysate-to-plasma ratio of creatinine (D/Pcr) and the dialysate protein concentration were measured and examined for their relationship with hypoalbuminaemia.
  
  
  RESULTS
  There was a significant positive correlation between serum IL-6 and dialysate IL-6, mean dialysate IL-6 being significantly higher than mean serum IL-6, suggesting that intraperitoneal inflammation was a principal origin of systemic inflammation. Both serum and dialysate IL-6 were significantly correlated with serum albumin (r= -0.25, P<0.05 and r=-0.32, P<0.01, respectively). Dialysate IL-6 was significantly correlated with D/Pcr and the dialysate protein concentration, and there was a significantly positive association between D/Pcr and the dialysate protein concentration. Dialysate CA125, which is argued to be a marker of mesothelial cell mass in this study, was positively correlated with D/Pcr and the dialysate protein concentration. The dialysate protein, dialysate IL-6 and dialysate CA125 all increased according to the peritoneal transport rate defined by D/Pcr. A multiple-regression analysis showed that serum albumin was independently associated with the age, D/Pcr and serum IL-6.
  
  
  CONCLUSIONS
  Hypoalbuminaemia was attributable to both the increased peritoneal permeability and systemic inflammation, and intraperitoneal inflammation might contribute to developing these complications.
authors.affiliation: Department of Clinical Nutrition, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan.
authors.forename: Masuyo
authors.initials: M
authors.lastname: Shioya
authors.forename: Takuya
authors.initials: T
authors.lastname: Yoshida
authors.forename: Kenji
authors.initials: K
authors.lastname: Kasai
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Furuya
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kato
authors.forename: Noriko
authors.initials: N
authors.lastname: Mori
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Kumagai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D018394:CA-125 Antigen / Q000097:blood; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D015314:Dialysis Solutions / Q000378:metabolism / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood / Q000209:etiology* / Q000276:immunology; D007249:Inflammation / Q000097:blood / Q000209:etiology* / Q000276:immunology; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D007564:Japan; D008297:Male; D008565:Membrane Proteins / Q000097:blood; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010537:Peritoneum / Q000378:metabolism; D010539:Permeability
chemical_list: D015415:Biomarkers; D018394:CA-125 Antigen; D015314:Dialysis Solutions; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; C451759:MUC16 protein, human; D008565:Membrane Proteins; D002097:C-Reactive Protein; D003404:Creatinine
keywords: CA125; dialysate; hypoalbuminaemia; inflammation; interleukin-6