Biomarker research to improve clinical outcomes of peritoneal dialysis: consensus of the European Training and Research in Peritoneal Dialysis (EuTRiPD) network

Aufricht, Christoph; Beelen, Robert H.J.; Eberl, Matthias; Fischbach, Michel; Fraser, Donald; Jörres, Achim; Kratochwill, Klaus; López–Cabrera, Manuel; Rutherford, Peter; Schmitt, Claus Peter; Topley, Nicholas; Witowski, Janusz

doi:10.1016/j.kint.2017.02.037

Cited by 41 publications

(55 citation statements)

References 112 publications

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“…Medicine treatment and ALB more than 35 g L −1 were beneficial for technical survival. Consistent with other previous reports, our study showed that cardiac events were the main cause of death [ 16–18 ] and peritonitis occurring during the peritoneal dialysis must be taken seriously [ 19 , 20 ].…”

Section: Discussionsupporting

confidence: 92%

Peritoneal dialysis in Sichuan province of China – report from the Chinese National Renal Data System

Xiu-ling

Wang

et al. 2018

Renal Failure

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Background: Peritoneal dialysis (PD) is one of the important treatment strategies for end stage renal disease (ESRD). In this study, we aimed to study the patients on PD of Sichuan province in the registry system and to explore the risk factors.Methods: This was a retrospective study based on data from the Chinese National Renal Data System (CNRDS). The outcomes were prevalence and incidence of patients receiving PD, all-cause mortality, technical failure, end events and peritonitis.Results: This study included 2654 patients between 1 January 2010 and 31 December 2016. From 2010 to 2016, despite there were increasing numbers of patients requiring PD. Primary and secondary glomerular diseases were the main causes of ESRD. Erythropoietin, iron and antihypertensive agents were the most commonly used medications in this cohort. 12.43% of patients died and the most important cause of death was cardiac events (30.30%). The incidences of peritonitis were 0.09, 0.16, 0.11, 0.09, 0.08, 0.12 and 0.06 per patient-year, respectively. The most common etiological agent of peritonitis was staphylococcus. We divided the patients into four groups according to the incident months of peritonitis. Compared with <20 months group, the level of calcium and platelet in >60 months group were higher, and the level of ferritin in >60 months group was lower.Conclusion: Our results, representing the first largest report of peritoneal dialysis in the Southwest of China, indicated increasing numbers of patients receiving peritoneal dialysis, which will require need for medical resource.

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Section: Discussionsupporting

confidence: 92%

Peritoneal dialysis in Sichuan province of China – report from the Chinese National Renal Data System

Xiu-ling

Wang

et al. 2018

Renal Failure

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“…20 The present study translates these prior findings of peritoneal membrane protection using the currently most accepted surrogate parameter of mesothelial cell status. 21 Importantly, these data are the first to demonstrate an increase of CA-125 on top of a dual-chamber PDF containing low glucose degradation products and physiologic pH.…”

Section: Discussionmentioning

confidence: 77%

“…[32][33][34][35] Therefore, an international consortium has recently proposed ex vivo-stimulated cytokine secretion assays from peritoneal cells as currently best biomarkers to monitor risk of peritonitis. 21 Previous studies have demonstrated depressed stimulated cytokine release from peritoneal cells obtained at early dwell times. 19,36 Importantly, at that time, conversion from migration of bacteria (e.g., after touch contamination) to infection may occur.…”

Section: Discussionmentioning

confidence: 99%

“…The performance of repeated PET studies in each patient allowed detecting significant effects of AlaGln despite a relatively small number of patients included. Use of 2 distinct biomarkers that recently have been suggested as best-in-class surrogate parameters for peritoneal membrane status and risk for infectious complications 21 represents a further strength of this study.…”

Section: Discussionmentioning

confidence: 99%

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A randomized controlled trial of alanyl-glutamine supplementation in peritoneal dialysis fluid to assess impact on biomarkers of peritoneal health

Vychytil¹,

Herzog²,

Probst³

et al. 2018

Kidney International

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“…5,6 The prolonged exposure to conventional PDS has been demonstrated to substantially contribute to peritoneal membrane injury and chronic low-grade inflammation 26 and a number of biomarkers have been evaluated in an attempt to help improve PD patient outcomes. 27 Acidic pH, high glucose concentrations and high levels of glucose degradation products in PDS have all been reported to cause local inflammation with resultant adverse functional outcomes, such as higher peritoneal solute transport rate (PSTR) and membrane failure due to fibrosis. Therefore, more bio-compatible PDS were developed aimed at mitigating some of these adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Targeting Toll-like receptors with soluble Toll-like receptor 2 prevents peritoneal dialysis solution–induced fibrosis

Raby

González-Mateo

Williams

et al. 2018

Kidney International

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Peritoneal membrane failure due to fibrosis limits the use of peritoneal dialysis (PD). Peritoneal fibrosis may potentially be induced by sterile inflammation caused by ongoing cellular stress due to prolonged exposure to PD solutions (PDS). Effective therapies to prevent this process remain to be developed. Toll-like receptors (TLRs) mediate sterile inflammation by recognizing damage-associated molecular patterns (DAMPs) released by cellular stress. We evaluated the involvement of TLRs and DAMPs in PDS-induced fibrosis models and the therapeutic potential of TLR-DAMP targeting for preventing fibrosis. A range of PDS elicited pro-inflammatory and fibrotic responses from PD patient peritoneal leukocytes, mesothelial cells and mouse peritoneal leukocytes. TLR2/4 blockade of human peritoneal cells or TLR2/4 knockouts inhibited these effects. PDS did not induce rapid ERK phosphorylation or IκB-α degradation, suggesting that they do not contain components capable of direct TLR activation. However, PDS increased the release of Hsp70 and hyaluronan, both TLR2/4 DAMP ligands, by human and mouse peritoneal cells, and their blockade decreased PDS-driven inflammation. Soluble TLR2, a TLR inhibitor, reduced PDS-induced pro-inflammatory and fibrotic cytokine release ex vivo. Daily catheter infusion of PDS in mice caused peritoneal fibrosis, but co-administration of soluble TLR2 prevented fibrosis, suppressed pro-fibrotic gene expression and pro-inflammatory cytokine production, reduced leukocyte/neutrophil recruitment, recovered Treg cell levels and increased the Treg:Th17 ratio. Thus, TLR2/4, Hsp70 and hyaluronan showed major roles in PDS-induced peritoneal inflammation and fibrosis. The study demonstrates the therapeutic potential of a TLR-DAMP targeting strategy to prevent PDS-induced fibrosis.

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Biomarker research to improve clinical outcomes of peritoneal dialysis: consensus of the European Training and Research in Peritoneal Dialysis (EuTRiPD) network

Cited by 41 publications

References 112 publications

Peritoneal dialysis in Sichuan province of China – report from the Chinese National Renal Data System

Peritoneal dialysis in Sichuan province of China – report from the Chinese National Renal Data System

A randomized controlled trial of alanyl-glutamine supplementation in peritoneal dialysis fluid to assess impact on biomarkers of peritoneal health

Targeting Toll-like receptors with soluble Toll-like receptor 2 prevents peritoneal dialysis solution–induced fibrosis

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