Effects of peritoneal dialysis on protein metabolism

Garibotto, Giacomo; Asioli, Sofia; Saffioti, Stefano; Bonanni, Alice; Mannucci, Irene; Parodi, E; Cademartori, Valeria; Verzola, Daniela

doi:10.1016/j.numecd.2012.07.005

Cited by 8 publications

(8 citation statements)

References 52 publications

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“…The relationship between nutritional status and physical activity is of special value in PD patients who are, on one side, at high risk of protein depletion, and on the other side at risk of obesity [8, 33]. In this clinical setting, implementation of a regular physical activity could contribute to maintain muscle mass and to increase energy expenditure.…”

Section: Discussionmentioning

confidence: 99%

Assessment of physical activity, capacity and nutritional status in elderly peritoneal dialysis patients

Cupisti

Finato²,

Corso

et al. 2017

BMC Nephrol

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BackgroundThis study aimed to evaluate the prevalence of sedentarism, and to assess physical capacity and nutritional status in a cohort of older patients on peritoneal dialysis (PD), with respect to age-matched non-dialysis CKD population, using highly accessible, simple methods, namely the Rapid Assessment of Physical activity (RAPA) test and the 30″ Sit-to-stand (STS) test.MethodsThis cross-sectional multicenter study included 151 renal patients older than 60 years; 71 pts. (44 m, age 72 ± 7 yrs) were on PD and 80 pts. (63 m, age 74 ± 7 yrs) were affected by 3–4 stage CKD.ResultsThe prevalence of sedentary/underactive patients was double of that of the active patients as assessed by RAPA test, both in the PD (65.3%) and in the CKD (67.5%) cohort.The 30"STS test showed a reduced physical performance in both groups: 84.5% of PD patients and 87.5% of CKD patients did not reach the expected number of stands by age and gender. A malnutrition-inflammation score (MIS) ≥ 6 occurred in 37 % of PD patients and in 2.5 % of CKD patients. In PD patients, an independent significant association was observed between 30”STS test and MIS (beta -0.510, p = 0.013), as well as between RAPA and MIS (beta -0.544, p = 003) and phase angle (beta -0.506, p = 0.028).ConclusionsA high prevalence of low- performance capacity and sedentarism has been detected among elderly patients on PD or with CKD stage 3–4. Apart from age, a condition of malnutrition-inflammation was the major determinant of poor physical activity and capacity in PD patients. Better body composition seems to be positively associated with physical activity in PD and with physical capacity in CKD patients. Routine clinical management should include a close evaluation of nutritional status and evaluation of physical activity and capacity which can be easily assessed by RAPA and 30″STS tests.

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Section: Discussionmentioning

confidence: 99%

Assessment of physical activity, capacity and nutritional status in elderly peritoneal dialysis patients

Cupisti

Finato²,

Corso

et al. 2017

BMC Nephrol

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show abstract

“…PD is known to promote malnutrition and excessive loss of free amino acids, essential fatty acids [55], and albumin [56], leading to muscle wasting [57]. The downregulation of leptin mRNA in peritoneal tissues from both EPS and PD patients (Figure S2) may reflect malnourishment in chronic PD patients, as serum leptin levels fall during long-term fasting [58].…”

Section: Discussionmentioning

confidence: 99%

Transcriptional Patterns in Peritoneal Tissue of Encapsulating Peritoneal Sclerosis, a Complication of Chronic Peritoneal Dialysis

et al. 2013

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Encapsulating peritoneal sclerosis (EPS) is a devastating complication of peritoneal dialysis (PD), characterized by marked inflammation and severe fibrosis of the peritoneum, and associated with high morbidity and mortality. EPS can occur years after termination of PD and, in severe cases, leads to intestinal obstruction and ileus requiring surgical intervention. Despite ongoing research, the pathogenesis of EPS remains unclear. We performed a global transcriptome analysis of peritoneal tissue specimens from EPS patients, PD patients without EPS, and uremic patients without history of PD or EPS (Uremic). Unsupervised and supervised bioinformatics analysis revealed distinct transcriptional patterns that discriminated these three clinical groups. The analysis identified a signature of 219 genes expressed differentially in EPS as compared to PD and Uremic groups. Canonical pathway analysis of differentially expressed genes showed enrichment in several pathways, including antigen presentation, dendritic cell maturation, B cell development, chemokine signaling and humoral and cellular immunity (P value<0.05). Further interactive network analysis depicted effects of EPS-associated genes on networks linked to inflammation, immunological response, and cell proliferation. Gene expression changes were confirmed by qRT-PCR for a subset of the differentially expressed genes. EPS patient tissues exhibited elevated expression of genes encoding sulfatase1, thrombospondin 1, fibronectin 1 and alpha smooth muscle actin, among many others, while in EPS and PD tissues mRNAs encoding leptin and retinol-binding protein 4 were markedly down-regulated, compared to Uremic group patients. Immunolocalization of Collagen 1 alpha 1 revealed that Col1a1 protein was predominantly expressed in the submesothelial compact zone of EPS patient peritoneal samples, whereas PD patient peritoneal samples exhibited homogenous Col1a1 staining throughout the tissue samples. The results are compatible with the hypothesis that encapsulating peritoneal sclerosis is a distinct pathological process from the simple peritoneal fibrosis that accompanies all PD treatment.

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“…Some studies have argued that increased albumin synthesis to compensate transperitoneal losses of albumin is usually reduced by inflammation [20].…”

Section: Discussionmentioning

confidence: 99%

“…In their study, Castellino et al [37] found that peritoneal dialysis patients had lower basal rates of protein degradation, leucine oxidation and whole body protein synthesis than the controls. All of these findings indicate that the human body is predisposed by peritoneal dialysis to decreased anabolism, which is detrimental if nutrient intake is reduced or during superimposed catabolic illnesses [20,38,39]. Another study found that peritoneal dialysis with dialysates that contained dextrose alone elevated insulin levels by up to 3 times as much, while decreasing amino acid levels by 20-25% [40].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Intraperitoneal Amino Acid and Oral Amino Acid Supplements in Peritoneal Dialysis Patients

Sarıkaya¹,

Bora²,

İnci³

et al. 2014

J Nephrol Ther

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Effects of peritoneal dialysis on protein metabolism

Cited by 8 publications

References 52 publications

Assessment of physical activity, capacity and nutritional status in elderly peritoneal dialysis patients

Assessment of physical activity, capacity and nutritional status in elderly peritoneal dialysis patients

Transcriptional Patterns in Peritoneal Tissue of Encapsulating Peritoneal Sclerosis, a Complication of Chronic Peritoneal Dialysis

Comparison of Intraperitoneal Amino Acid and Oral Amino Acid Supplements in Peritoneal Dialysis Patients

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