title: Biocompatible Dialysis Solutions Preserve Peritoneal Mesothelial Cell and Vessel Wall Integrity. A Case-Control Study on Human Biopsies.
abstract: ♦
  
  
  BACKGROUND
  Chronic exposure to conventional peritoneal dialysis (PD) solutions has been related to peritoneal function alterations in PD patients, and associated with mesothelial cell loss, submesothelial fibrosis, vasculopathy, and angiogenesis. In vitro and ex vivo analyses, as well as studies with animal models, have demonstrated that biocompatible PD solutions attenuate these morphological alterations. Our aim was to confirm the morphological benefits of biocompatible solutions in PD patients. ♦
  
  
  METHODS
  We analyzed biopsies from 23 patients treated with biocompatible solutions (study group, SG), and compared them with a control group (n = 23) treated with conventional solutions (CG), matched for time on PD. ♦
  
  
  RESULTS
  A total of 56.5% of SG patients showed total or partial preservation of mesothelial cells monolayer, in contrast with 26.1% of patients in CG (p = 0.036). Peritoneal fibrosis was not significantly less frequent in SG patients (47.8% SG vs 69.6% CG; p = 0.13). In patients without previous peritonitis, a significantly lower prevalence of fibrosis was present in SG patients (41.7% SG vs 77.8% CG; p = 0.04). Hyalinizing vasculopathy (HV) was significantly lower in SG (4.3% SG vs 30.4% CG; p = 0.02). Cytokeratin-positive fibroblast-like cells were detected in 10 patients (22%), but the prevalence was not significantly lower in SG. In the univariate regression analysis, the use of biocompatible solutions was associated with mesothelial monolayer integrity (p = 0.04) and an absence of vasculopathy (p = 0.04). ♦
  
  
  CONCLUSIONS
  The present study demonstrates in vivo in human biopsies that biocompatible solutions are better tolerated by the peritoneum in the medium and long term than conventional solutions.
authors.affiliation: Servicio de Nefrología, Instituto de Investigación (IdiPAZ), Hospital Universitario La Paz, Madrid, Spain gloria.delpeso@salud.madrid.org.
authors.forename: Gloria
authors.initials: G
authors.lastname: del Peso
authors.affiliation: Servicio de Anatomía Patológica, Instituto de Investigación Sanitaria (IIS-IP), Hospital Universitario La Princesa, Madrid, Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Jiménez-Heffernan
authors.affiliation: Servicio de Nefrología, Instituto de Investigación (IdiPAZ), Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Selgas
authors.affiliation: Servicio de Nefrología Hospital Puerto Real, Cádiz, Spain.
authors.forename: César
authors.initials: C
authors.lastname: Remón
authors.affiliation: Servicio de Nefrología, Instituto de Investigación (IdiPAZ), Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Ossorio
authors.affiliation: Servicio de Nefrología, Instituto de Investigación Sanitaria (IIS-IP), Hospital Universitario La Princesa, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Fernández-Perpén
authors.affiliation: Servicio de Nefrología, Instituto de Investigación Sanitaria (IIS-IP), Hospital Universitario La Princesa, Madrid, Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Sánchez-Tomero
authors.affiliation: Servicio de Nefrología, Hospital Infanta Sofía, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cirugeda
authors.affiliation: Servicio de Nefrología, Instituto de Investigación (IdiPAZ), Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Erika
authors.initials: E
authors.lastname: de Sousa
authors.affiliation: Centro de Biología Molecular Severo Ochoa, CSIC-UAM, Madrid, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Sandoval
authors.affiliation: Servicio de Nefrología, Instituto de Investigación (IdiPAZ), Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Díaz
authors.affiliation: Centro de Biología Molecular Severo Ochoa, CSIC-UAM, Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: López-Cabrera
authors.affiliation: Servicio de Nefrología, Instituto de Investigación (IdiPAZ), Hospital Universitario La Paz, Madrid, Spain.
authors.forename: María Auxiliadora
authors.initials: MA
authors.lastname: Bajo
mesh_terms: D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use; D001706:Biopsy; D001808:Blood Vessels / Q000187:drug effects*; D016022:Case-Control Studies; D015314:Dialysis Solutions / Q000627:therapeutic use*; D004847:Epithelial Cells / Q000187:drug effects* / Q000378:metabolism; D058750:Epithelial-Mesenchymal Transition; D005260:Female; D006801:Humans; D007633:Keratins / Q000378:metabolism; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010537:Peritoneum / Q000187:drug effects* / Q000378:metabolism
chemical_list: D001672:Biocompatible Materials; D015314:Dialysis Solutions; D007633:Keratins
keywords: Peritoneal biopsy; biocompatible dialysis solutions; hyalinizing vasculopathy; mesothelial cell integrity; submesothelial fibrosis