Longitudinal Changes of PAI-1, MMP-2, and VEGF in Peritoneal Effluents and Their Associations with Peritoneal Small-Solute Transfer Rate in New Peritoneal Dialysis Patients.

Na Hao,Jin-Bor Chen,Terry Ting-Yu Chiou,Mei-Chen Chao,Yang-Yang Lei,Pei-Ling Liang,Chien-Hsing Wu,Hongtao Yang

doi:10.1155/2019/2152584

Abstract

Patients on peritoneal dialysis (PD) encounter peritoneal functional and structural alterations. It is still unknown whether levels of plasminogen activator inhibitor type 1 (PAI-1), matrix metalloproteinases- (MMP-) 2, and vascular endothelial growth factor (VEGF) exhibit dynamic changes in peritoneal effluents. The aim of the present study was to investigate the longitudinal changes in these biomarkers in PD patients and their association with peritoneal small-solute transfer rate (PSTR). This prospective, single-center cohort study included 70 new PD patients. The presence of PAI-1, MMP-2, and VEGF in peritoneal effluents was measured regularly after PD initiation. The association between those biomarkers and 4-hour effluent:plasma creatinine ratio (PSTR) was analyzed. Longitudinal follow-up showed a tendency for PAI-1 (p < 0.001) and VEGF (p = 0.04) to increase with the duration of PD. Both PSTR at baseline and PSTR at 2 years significantly associated with PAI-1, MMP-2, and VEGF levels at baseline. PSTR at 2 years also associated with the MMP-2 level at 6 months and PAI-1 level at baseline. The present study illustrated a positive association of PSTR with selected biomarkers in peritoneal effluents observed over a 2-year period.

Highlights

Peritoneal dialysis (PD) is one of the renal replacement therapies employed in end-stage renal disease
Basic principle in peritoneal equilibration test (PET) is obtained under certain conditions of peritoneal fluid and creatinine and the ratio of glucose in the blood determine the type of patients with peritoneal transport
Forty-one patients were treated with continuous ambulatory peritoneal dialysis (CAPD), 21 with ambulatory peritoneal dialysis (APD), and eight with CAPD+APD

Summary

Introduction

Peritoneal dialysis (PD) is one of the renal replacement therapies employed in end-stage renal disease. Most common PD solution is glucose-based in clinical practice. There have been previous reports that peritoneal injury inferred from glucose-based PD solution in long-term dwell could lead to peritoneal functional and structural changes [1,2,3]. Peritoneal equilibration test (PET) is commonly applied to examine the solute transport rate in PD. Basic principle in PET is obtained under certain conditions of peritoneal fluid and creatinine and the ratio of glucose in the blood determine the type of patients with peritoneal transport. PET is cumbersome for sampling measurement and is time-consuming Considering these disadvantages, several biomarkers that can be measured in the blood or PD effluent have been reported to be complementary indicators of peritoneal injury during PD therapy

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