Abstract
BackgroundHepatocyte growth factor (HGF) counteracts peritoneal fibrosis in animal models and in-vitro studies, but no study explored effluent HGF in peritoneal dialysis (PD) patients with ultrafiltration failure (UFF). Our aim was to assess the relationship between effluent HGF with UF profile, free water transport (FWT) and small-solute transport.MethodsWe performed 4-hour, 3.86% PET with additional UF measurement at 60 minutes in 68 PD patients. MTACcreatinine, FWT, small-pore ultrafiltration, and effluent HGF were quantified.ResultsEffluent HGF negatively correlated with UF (r = −0.80, p = 0.009) and FWT (r = −0.69, p = 0.04). Patients with UFF had higher dialysate HGF (103 pg/mL vs 77 pg/mL, p = 0.018) and, although not statistically significant, those with FWT compromise had also higher dialysate HGF compared with subgroup of UFF without FWT compromise (104 pg/mL vs 88 pg/mL, p = 0.08). FWT ≤ 45% without clinical UFF was documented in some patients who also had increased effluent HGF.ConclusionsDialysate HGF concentration is significantly higher among patients with UFF, specially, if FWT is impaired, being a sign of peritoneal membrane deterioration.
Highlights
Hepatocyte growth factor (HGF) counteracts peritoneal fibrosis in animal models and in-vitro studies, but no study explored effluent HGF in peritoneal dialysis (PD) patients with ultrafiltration failure (UFF)
Since it is known that increased submesothelial fibrosis is an early and progressive lesion associated with UFF [8], the search for an effluent marker related to membrane fibrosis process and exhibiting a good correlation with ultrafiltration and free water transport (FWT) would be clinically important
Concerning water transport pathways, FWT accounted for 37.15% of the UF at 60 minutes, and once corrected, its contribution increased to a mean value of 45.46%
Summary
Hepatocyte growth factor (HGF) counteracts peritoneal fibrosis in animal models and in-vitro studies, but no study explored effluent HGF in peritoneal dialysis (PD) patients with ultrafiltration failure (UFF). In long-term patients, UFF is more severe and often associated with free water transport (FWT) compromise [4,5,6]. Since it is known that increased submesothelial fibrosis is an early and progressive lesion associated with UFF [8], the search for an effluent marker related to membrane fibrosis process and exhibiting a good correlation with ultrafiltration and FWT would be clinically important. Such a marker could timely detect peritoneal membrane failure.
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