Continuous Mesothelial Injury and Regeneration during long Term Peritoneal Dialysis

Abstract

This study reconstructs the whole sequence of mesothelial injury and regeneration in patients on longterm peritoneal dialysis. Our observations indicate that peritoneal dialysis induces a process of continuous mesothelial injury and regeneration. New mesothelial cells seem to originate from wandering mesothelial cells of the peritoneal fluid, as well as from mesothelial cell precursors localized in the sub-mesothelial connective tissue.

Effect of iron sucrose on human peritoneal mesothelial cells

“…However in these cells, iron was still present in the cytosol and increased generation of free radicals was observed. One can therefore speculate that repeated intraperitoneal infusion of the dialysis fluid supplemented with iron may cause progressive death of the mesothelial cells and accelerate their turnover, finally leading to exhaustion of the mesothelial capability for regeneration [20]. Potential prooxidant action of iron was also shown in other experimental models, including uraemia [21–23].…”

Monitoring of the peritoneal membrane

“…Peritoneal biopsies show that PD leads to signs of mesothelial degeneration and regeneration [ 6–12 ], including replacement of the mesothelial cell layer by a thick fibrous band in long-term PD patients [ 12–14 ]. Also, acute infectious peritonitis can result in discontinuity or denudation of the mesothelial layer [ 8 , 12–15 ]. Remesothelialization occurs after the infection has been cured but it might be incomplete [ 8 , 13 , 16 ].…”

“…Also, acute infectious peritonitis can result in discontinuity or denudation of the mesothelial layer [ 8 , 12–15 ]. Remesothelialization occurs after the infection has been cured but it might be incomplete [ 8 , 13 , 16 ]. Mesothelial cell cultures from effluents during PD show various morphologic features ranging from a cobblestone-like appearance to fibroblast-like cells or mixed cell populations [ 17 ].…”

Basic Science and Dialysis: Response of the Peritoneal Membrane to Injury

“…Due to Long-term PD Numerous studies have documented the bioinconipatibility of conventional dialysis solutions (49)(50)(51)(52). Thus, the process of PD can, in effect, be considered a type of chronic injury to the peritoneal membrane (53). Current nonphysiological dialysis solutions have been shown to contribute to the presence of a sterile, inflammatory state in the peritoneal cavity (54, 5.3, to detrimentally affect peritoneal defense mechanisms (56)(57)(58), and to result in changes in peritoneal transport properties (59).…”