Influencing factors for residual kidney function in incident peritoneal dialysis patients: a systematic review and meta-analysis

Zhou, Dan; Lei, Hong; Wu, Shuran; Yang, Wei; Cui, Wenting; Li, Longkai; Lin, Hongli; Yin, Anchun

doi:10.1080/0886022x.2023.2286328

Cited by 1 publication

(1 citation statement)

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“…This alteration may result in a reduction in microbial diversity and the disruption of the gut's protective mechanisms, creating an environment conducive to the overgrowth of indole-producing bacteria [36,37]. Second, peritonitis experience may lead to a decline in RKF and an increase in peritoneal transport status [38,39].…”

Section: Discussionmentioning

confidence: 99%

Association between serum total indoxyl sulfate, intraperitoneal inflammation, and peritoneal dialysis technique failure: a 3-year prospective cohort study

Stepanova,

Driianska,

Korol

et al. 2024

Preprint

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Background The impact of protein-bound uremic toxins, specifically indoxyl sulfate (IS) on peritoneal dialysis (PD) complications remains controversial. This study aimed to explore the link between serum total IS (tIS) levels, proinflammatory cytokines in serum and peritoneal dialysate effluent (PDE), and PD techniques survival. Methods In this prospective cohort study, 84 patients were followed up for three years and analyzed. Stratification into Low tIS (< 22.6 µmol/L) and High tIS (≥ 22.6 µmol/L) groups was based on the median serum tIS concentration. Logistic regression, Kaplan-Meier, receiving operation characteristic, and Cox regression analyses assessed associations between tIS levels, cytokine concentrations (IL-6, MCP-1, TNF-α), and PD technique failure. Results The High tIS group exhibited poor clinical characteristics compared with the Low-tIS group. Elevated tIS levels significantly correlated with higher PDE cytokine levels, without a corresponding rise in serum cytokine levels. Serum tIS levels ≥ 50 µmol/L predicted PD technique failure with 70.4% sensitivity and 87.9% specificity (p < 0.0001). The association between high tIS levels and PD technique failure persisted after adjusting for relevant factors (HR 3.14, 95% CI 1.13; 8.72), but the inclusion of PDE cytokines in the model diminished this association (HR 2.18, 95% CI 0.93; 5.14). Conclusion Our findings underscore the link between elevated tIS levels, peritoneal inflammation, and an increased risk of PD technique failure. Monitoring tIS levels in PD patients may be clinically relevant for risk assessment and personalized management, potentially enhancing long-term PD outcomes. Future research could explore interventions targeting tIS reduction to alleviate peritoneal inflammation and improve PD prognosis.

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Section: Discussionmentioning

confidence: 99%