Is peritoneal dialysis causing a measurable burden of inflammatory and endothelial injury on top of metabolic syndrome?
OBJECTIVE
Low-grade chronic inflammation is present in patients on peritoneal dialysis (PD) and in metabolic syndrome (MS). Due to possible greater endothelial changes in dialyzed patients, inflammatory response and oxidative stress are probably stronger in patients on PD. The objective of the study was to investigate possible in between adipokines, inflammatory, endothelial and oxidative stress markers between MS patients and patients on PD.


METHODS
Concentrations of adipokines (leptin, resistin), inflammatory markers [interleukin-6 (IL-6), soluble tumor necrosis factor alpha receptor (sTNF-R), myeloperoxidase (MPO), monocyte chemoattractant protein 1 (MCP-1)] and endothelial markers [soluble intracellular adhesion molecule-1 (sICAM-1), soluble CD40 ligand (sCD40L)] were determined in 55 MS patients and 18 patients on PD, with flow cytometry, and visfatin concentration was measured with ELISA. Routine biochemistry parameters were measured on Beckman Coulter AU2700 analyzer.


RESULTS
Patients on PD have significantly higher concentration of: CRP [6.5 (3.7-12.1) versus 2.6 (1.3-4.0) mg/L, P < 0.001], IL-6 [13.83 (8.48-31.31) versus 2.05 (0.67-4.11) pg/mL, P < 0.001], MCP-1 [2172.28 (1563.84-2922.77) versus 1353.58 (1166.33-1961.70) pg/mL, P = 0.023], sTNF-R [18.25 (12.81-25.22) versus 1.23 (0.89-1.43) ng/mL, P < 0.001] and sICAM-1 [830.03 (599.21-967.02) versus 463.85 (315.25-751.71) ng/mL, P = 0.006] than subjects with MS. MS patients have higher concentrations of MPO [175.47 (120.15-231.67) versus 101.76 (53.55-186.06) ng/mL, P = 0.016] and visfatin [1.5 (0.9-2.3) versus 0.9 (0.6-1.6) ng/mL, P = 0.013].


CONCLUSIONS
In patients on PD, inflammatory reaction is higher than in patients with MS. On the contrary, patients with MS have stronger oxidative stress response and adipose tissue activity caused probably by the chronic low level of inflammation and underlying metabolic disorders.
University Department of Chemistry, Sestre Milosrdnice Medical School University Hospital, Zagreb, Croatia. marijana.miler@gmail.com.
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Miler
University Department of Chemistry, Sestre Milosrdnice Medical School University Hospital, Zagreb, Croatia.
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Nikolac
Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia.
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Segulja
Medical Biochemistry Laboratory, Policlinic Bonifarm, Zagreb, Croatia.
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Kackov Maslac
University Department of Chemistry, Sestre Milosrdnice Medical School University Hospital, Zagreb, Croatia.
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Celap
Department of Nephrology and Dialysis, Medical School University Hospital Sestre Milosrdnice, Zagreb, Croatia.
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Altabas
Department of Nephrology and Dialysis, Medical School University Hospital Sestre Milosrdnice, Zagreb, Croatia.
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Sefer
Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia.
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Simundic
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000293:injuries / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology* / Q000628:therapy; D008875:Middle Aged; D018384:Oxidative Stress; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D011379:Prognosis; D012307:Risk Factors
D015415:Biomarkers; D018836:Inflammation Mediators
Adipokines; Endothelial impairment; Inflammation; Metabolic syndrome; Oxidative stress; Peritoneal dialysis