title: Peritoneal Cell-free DNA: an innovative method for determining acute cell damage in peritoneal membrane and for monitoring the recovery process after peritonitis.
abstract: BACKGROUND
  Cell-free DNA (cfDNA) is present in the peritoneal effluent of stable peritoneal dialysis (PD) patients, but there are no data on cfDNA in PD patients with peritonitis. We investigated the variation of peritoneal cfDNA levels subsequent to peritonitis in PD patients.
  
  
  METHODS
  We enrolled 53 PD patients: 30 without any history of systemic inflammation or peritonitis in the last 3 months (group A) and 23 with acute peritonitis (group B). CfDNA was quantified in the peritoneal effluent. Peritoneal samples on days 1, 3, 10, 30 and until day 120 from the start of peritonitis were collected for white blood cells (WBC) count and cfDNA evaluation in group B.
  
  
  RESULTS
  Quantitative analysis of cfDNA showed significantly higher levels in group B on day 1, 3, 10 and 30 compared with group A (p < 0.05). A significant positive correlation was observed between cfDNA concentration and WBC on day 1 (rho = 0.89) and day 3 (rho = 0.5) (both, p < 0.05). However, no significant correlation was observed between cfDNA and WBC on days 10 and 30. In group B, peritoneal cfDNA levels tended to progressively decline during follow-up of peritonitis. From this decreasing curve, we estimated that 49 days are necessary to reach the value of 51 genome equivalents (GE)/ml (75th percentile in controls) and 63 days to reach 31 GE/ml (median).
  
  
  CONCLUSIONS
  Our results demonstrate that cfDNA increases in peritoneal effluent of PD patients with peritonitis and tends to progressively decline in step with peritonitis resolution and membrane repair process. Peritoneal cfDNA quantification could be an innovative method to determine acute damage and an inverse index of the repair process.
authors.affiliation: IRRIV-International Renal Research Institute Vicenza, Vicenza, Italy. graziamaria.virzi@gmail.com.|Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Via Rodolfi, 37 - 36100, Vicenza, Italy. graziamaria.virzi@gmail.com.
authors.forename: Grazia Maria
authors.initials: GM
authors.lastname: Virzì
authors.affiliation: IRRIV-International Renal Research Institute Vicenza, Vicenza, Italy.|Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Via Rodolfi, 37 - 36100, Vicenza, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Milan Manani
authors.affiliation: IRRIV-International Renal Research Institute Vicenza, Vicenza, Italy.|Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Via Rodolfi, 37 - 36100, Vicenza, Italy.|Department of Medicine DIMED, University of Padua Medical School, Padua, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Brocca
authors.affiliation: Nephrology, Dialysis and Kidney Transplantation Unit, Department of Medical Sciences, Azienda Ospedaliera "Città della Salute e della Scienza di Torino- Presidio Molinette", University of Turin, Turin, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cantaluppi
authors.affiliation: IRRIV-International Renal Research Institute Vicenza, Vicenza, Italy.|Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Via Rodolfi, 37 - 36100, Vicenza, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: de Cal
authors.affiliation: IRRIV-International Renal Research Institute Vicenza, Vicenza, Italy.|Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Via Rodolfi, 37 - 36100, Vicenza, Italy.|Department of Information Engineering, University of Padua, Padua, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Pastori
authors.affiliation: IRRIV-International Renal Research Institute Vicenza, Vicenza, Italy.|Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Via Rodolfi, 37 - 36100, Vicenza, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Tantillo
authors.affiliation: Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Via Rodolfi, 37 - 36100, Vicenza, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Zambon
authors.affiliation: IRRIV-International Renal Research Institute Vicenza, Vicenza, Italy.|Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Via Rodolfi, 37 - 36100, Vicenza, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Crepaldi
authors.affiliation: IRRIV-International Renal Research Institute Vicenza, Vicenza, Italy.|Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Via Rodolfi, 37 - 36100, Vicenza, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D001202:Ascitic Fluid / Q000378:metabolism*; D003430:Cross-Sectional Studies; D004247:DNA / Q000235:genetics* / Q000378:metabolism; D005260:Female; D005819:Genetic Markers; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000401:mortality; D010537:Peritoneum / Q000378:metabolism* / Q000473:pathology; D010538:Peritonitis / Q000175:diagnosis* / Q000209:etiology / Q000235:genetics* / Q000401:mortality / Q000628:therapy; D010865:Pilot Projects; D011237:Predictive Value of Tests; D060888:Real-Time Polymerase Chain Reaction; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005819:Genetic Markers; D004247:DNA
keywords: Cell free DNA; Peritoneal dialysis; Peritoneal membrane; Peritonitis; Recovery process