Influence of local inflammation of the peritoneal membrane on diuresis and residual renal function in patients treated with peritoneal dialysis

Abstract

The aim of this study was to investigate the connection between local inflammation of the peritoneal membrane and diuresis, as well as the residual renal function (RRF) in patients treated with continuous ambulatory peritoneal dialysis (CAPD). Twenty patients treated with CAPD participated in this cross-sectional study. To determine the influence of local inflammation of the peritoneal membrane, effluent interleukin-6 (IL-6) and soluble interleukin-6 receptor (sIL-6R) levels were measured. The level of IL-6, in the group as a whole, was significantly higher in effluent (7.87 pg/mL) than in serum (1.29 pg/mL). There was a significant correlation between effluent and serum IL-6 (r = 0.608; P = 0.002). There was also a significant relationship between effluent and serum IL-6 and duration of CAPD treatment, respectively (r = 0.577; P = 0.004; r = 0.528; P = 0.008). Further, there was a significant negative correlation between effluent IL-6 and daily diuresis (r = -0.533; P = 0.008), but there was no significant correlation between effluent IL-6 and RRF (r = -0.339, P = 0.072). On the other hand, the concentrations of effluent IL-6 were significantly higher in patients with RRF <2 mL/min than in those with RRF ≥2 mL/min (P = 0.039). In conclusion, local inflammation has a significant impact on the amount of diuresis and probably on RRF in patients on CAPD.

Isolation of interstitial fluid and demonstration of local proinflammatory cytokine production and increased absorptive gradient in chronic peritoneal dialysis

“…The time point chosen in the present study, however, was based on the assumption that 8 wk of PD for a rat corresponds to a patient under long-term PD. Jelicic et al (9) have shown that PD patients have a positive correlation between time on PD and the levels of IL-6 in the peritoneal effluent as well as in plasma, and a higher concentration in effluent compared with plasma, indicating local inflammation that is also reflected systemically. Furthermore, we found that in rats that were exposed to a chronic catheter, but without PD, the hyaluronan and collagen deposition in the interstitial matrix increased to almost the same magnitude as in the dialyzed group.…”

Relationship between red blood cell distribution width and early-stage renal function damage in patients with essential hypertension

“…Inflammation plays an important role in the pathogenesis of renal function damage, particularly in the presence of hypertension [20][21][22][23]. It has been suggested that some inflammatory cytokines are significantly related to ineffective erythropoiesis, such as interleukin-1b, IL-6, and tumor necrosis factor-a (TNF-a) that inhibit red blood cell maturation and promote anisocytosis [24,25].…”

Higher Serum Hepatocyte Growth Factor Concentration is Associated with Better Preservation of GFR in Hemodialysis Patients

“…However, a surprising finding was the lack of correlation between increase of serum IL6 during the whole study and decrease of GFR. Also, Jelicic et al found in peritoneal dialysis patients that the effluent IL6 level correlated with residual diuresis but not with GFR [9]. It seems that the stimulated synthesis of IL6 in endothelial cells observed in our experiments after their exposure to serum samples harvested from the patients could reflect their activation by progressing uremia and treatment with hemodialysis [19].…”

“…Recently, Borges et al described the relationship between residual diuresis in patients on hemodialysis and the serum level of CRP [8]. Other authors suggested a link between intraperitoneal IL6 level in patients treated with chronic peritoneal dialysis and their residual renal diuresis [9]. In another study on peritoneal dialysis patients a correlation between serum FGF21 level and residual renal function was described [10].…”