title: Matrix metalloproteinase-2 as a superior biomarker for peritoneal deterioration in peritoneal dialysis.
abstract: OBJECTIVE
  To investigate the efficacy of effluent biomarkers for peritoneal deterioration with functional decline in peritoneal dialysis (PD).
  
  
  METHODS
  From January 2005 to March 2013, the subjects included 218 PD patients with end-stage renal disease at 18 centers. Matrix metalloproteinase-2 (MMP-2), interleukin-6 (IL-6), hyaluronan, and cancer antigen 125 (CA125) in peritoneal effluent were quantified with enzyme-linked immunosorbent assay. Peritoneal solute transport rate was assessed by peritoneal equilibration test (PET) to estimate peritoneal deterioration.
  
  
  RESULTS
  The ratio of the effluent level of creatinine (Cr) obtained 4 h after injection (D) to that of plasma was correlated with the effluent levels of MMP-2 (ρ = 0.74, P < 0.001), IL-6 (ρ = 0.46, P < 0.001), and hyaluronan (ρ = 0.27, P < 0.001), but not CA125 (ρ = 0.13, P = 0.051). The area under receiver operating characteristic curve for the effluent levels of MMP-2, IL-6, and hyaluronan against high PET category were 0.90, 0.78, 0.62, and 0.51, respectively. No patient developed new-onset encapsulating peritoneal sclerosis for at least 1.5 years after peritoneal effluent sampling.
  
  
  CONCLUSIONS
  The effluent MMP-2 level most closely reflected peritoneal solute transport rate. MMP-2 can be a reliable indicator of peritoneal deterioration with functional decline.
authors.affiliation: Ichiro Hirahara, Eiji Kusano, Yoshiyuki Morishita, Makoto Inoue, Tetsu Akimoto, Osamu Saito, Shigeaki Muto, Daisuke Nagata, Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Hirahara
authors.affiliation: Ichiro Hirahara, Eiji Kusano, Yoshiyuki Morishita, Makoto Inoue, Tetsu Akimoto, Osamu Saito, Shigeaki Muto, Daisuke Nagata, Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kusano
authors.affiliation: Ichiro Hirahara, Eiji Kusano, Yoshiyuki Morishita, Makoto Inoue, Tetsu Akimoto, Osamu Saito, Shigeaki Muto, Daisuke Nagata, Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Morishita
authors.affiliation: Ichiro Hirahara, Eiji Kusano, Yoshiyuki Morishita, Makoto Inoue, Tetsu Akimoto, Osamu Saito, Shigeaki Muto, Daisuke Nagata, Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Ichiro Hirahara, Eiji Kusano, Yoshiyuki Morishita, Makoto Inoue, Tetsu Akimoto, Osamu Saito, Shigeaki Muto, Daisuke Nagata, Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Tetsu
authors.initials: T
authors.lastname: Akimoto
authors.affiliation: Ichiro Hirahara, Eiji Kusano, Yoshiyuki Morishita, Makoto Inoue, Tetsu Akimoto, Osamu Saito, Shigeaki Muto, Daisuke Nagata, Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Saito
authors.affiliation: Ichiro Hirahara, Eiji Kusano, Yoshiyuki Morishita, Makoto Inoue, Tetsu Akimoto, Osamu Saito, Shigeaki Muto, Daisuke Nagata, Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Muto
authors.affiliation: Ichiro Hirahara, Eiji Kusano, Yoshiyuki Morishita, Makoto Inoue, Tetsu Akimoto, Osamu Saito, Shigeaki Muto, Daisuke Nagata, Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nagata
keywords: Encapsulating peritoneal sclerosis; Matrix metalloproteinase-2; Peritoneal deterioration; Peritoneal dialysis; Peritoneal solute transport