title: Dialysate cytokine levels do not predict encapsulating peritoneal sclerosis.
abstract: BACKGROUND
  Encapsulating peritoneal sclerosis (EPS) is a rare but devastating complication of long-term peritoneal dialysis (PD). There is no well-validated method for predicting which patients will develop the condition, although known risk factors include long duration of PD, high glucose exposure and lack of residual renal function. We have investigated whether dialysate cytokines (MCP-1 (monocyte chemotactic protein-1), CCL18 (pulmonary and activation-regulated cytokine, PARC), IL-6 (interleukin-6), CCL15 (leukotactin) and angiogenin) could be used to predict the onset of EPS more effectively than known clinical risk factors.
  
  
  METHODS
  Samples of dialysate and clinical data were prospectively collected from 151 patients at the West London Renal center between 2003 and 2010. Dialysate cytokine levels were measured using the enzyme-linked immunoabsorbant assay (ELISA) technique. Encapsulating peritoneal sclerosis subsequently developed in 17 patients during a follow-up period of 27 - 113 months. Cytokines found at higher levels in dialysate of pre-EPS patients were investigated as candidate predictors of EPS using logistic regression analysis.
  
  
  RESULTS
  Dialysate IL-6, MCP-1 and CCL15 were significantly higher in patients who subsequently developed EPS; however, a logistic regression model using dialysate cytokines to predict EPS was no better than a model using well-recognized clinical markers (length of time on PD and membrane transport status).
  
  
  CONCLUSIONS
  Although MCP-1, IL-6 and CCL15 were found at higher levels in the dialysate of patients who subsequently developed EPS, dialysate levels of these cytokines do not improve prediction of future EPS above a model using known clinical risk factors.
authors.affiliation: Renal Section, Department of Medicine, Imperial College, London, United Kingdom; and Senior Statistician, Queen Mary University of London, London, United Kingdom.
authors.forename: Catriona
authors.initials: C
authors.lastname: Goodlad
authors.affiliation: Renal Section, Department of Medicine, Imperial College, London, United Kingdom; and Senior Statistician, Queen Mary University of London, London, United Kingdom.
authors.forename: Frederick W K
authors.initials: FW
authors.lastname: Tam
authors.affiliation: Renal Section, Department of Medicine, Imperial College, London, United Kingdom; and Senior Statistician, Queen Mary University of London, London, United Kingdom.
authors.forename: Sohail
authors.initials: S
authors.lastname: Ahmad
authors.affiliation: Renal Section, Department of Medicine, Imperial College, London, United Kingdom; and Senior Statistician, Queen Mary University of London, London, United Kingdom.
authors.forename: Gurjeet
authors.initials: G
authors.lastname: Bhangal
authors.affiliation: Renal Section, Department of Medicine, Imperial College, London, United Kingdom; and Senior Statistician, Queen Mary University of London, London, United Kingdom.
authors.forename: Bernard V
authors.initials: BV
authors.lastname: North
authors.affiliation: Renal Section, Department of Medicine, Imperial College, London, United Kingdom; and Senior Statistician, Queen Mary University of London, London, United Kingdom.
authors.forename: Edwina A
authors.initials: EA
authors.lastname: Brown
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis; D018932:Chemokine CCL2 / Q000032:analysis; D019742:Chemokines, CC / Q000032:analysis; D015331:Cohort Studies; D016207:Cytokines / Q000032:analysis / Q000378:metabolism*; D015314:Dialysis Solutions / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis; D016015:Logistic Models; D019402:Macrophage Inflammatory Proteins / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D056627:Peritoneal Fibrosis / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; C108814:CCL15 protein, human; C111792:CCL18 protein, human; D018932:Chemokine CCL2; D019742:Chemokines, CC; D016207:Cytokines; D015314:Dialysis Solutions; D015850:Interleukin-6; D019402:Macrophage Inflammatory Proteins
keywords: Cytokines; encapsulating peritoneal sclerosis; screening