Peritoneal calprotectin level in peritoneal dialysis patients

Abstract

Background: Calprotectin is an important molecule in the initiation and progression of the inflammatory process. Systemic and local intraperitoneal inflammation are distinct processes and consequences in peritoneal dialysis (PD). We aimed to evaluate dialysate calprotectin levels and its associations with peritonitis and dialysis adequacy in PD patients.Methods: Forty-four PD patients were included in this prospective study. Calprotectin concentration was evaluated in 24-h peritoneal drainage fluid. Patients were followed-up for 1 year, and peritonitis episodes were recorded. Dialysate calprotectin levels were compared to dialysis adequacy parameters and peritonitis frequency.Results: The mean age of patients was 54.9±12.7 years. Median PD duration was 54 (23-76) months. Seventeen patients (38.6%) had previous peritonitis episodes.During follow-up, 15 of 44 patients (34.1%) had peritonitis. The median calprotectin concentration was 79.5 (75.2-86.3) ng/ml. The patients were divided into low and high calprotectin groups according to median value. In the high calprotectin group, BMI was found higher (p = 0.04). There was no significant relationship between calprotectin concentration and peritonitis during follow-up (p = 0.29). However, the patients that have had previous peritonitis had higher calprotectin concentrations (p = 0.02). The patients who had higher erythrocyte sedimentation rate (ESR) levels also had higher calprotectin concentrations (p = 0.01). Conclusion:Peritoneal calprotectin concentrations were correlated with higher BMI and ESR, and it was higher in patients with previous peritonitis episodes. To our knowledge, this is the first study to examine the peritoneal calprotectin levels in PD patients. Further studies are needed to determine the use of peritoneal calprotectin as an inflammatory marker in PD. | INTRODUCTIONPeritoneal dialysis (PD) is one of the treatment modalities for endstage renal disease (ESRD) patients. Continuous exposure to bioincompatible PD solutions causes structural and functional alterations in the peritoneal membrane during PD. Increased peritoneal solute transport rate (PSTR) is the most common functional alteration, leading to impaired ultrafiltration, inadequate dialysis, and PD treatment discontinuation. 1 Since adequate dialysis provides more prolonged PD treatment and improves quality of life, higher PSTR is an accepted risk factor for technique failure and mortality in PD patients. 2 Peritonitis is a frequent complication of PD which impairs dialysis adequacy and increases morbidity and mortality in PD patients, and it is the leading cause of technique failure. 3,4 It is essential to determine the patients who are at high risk for peritonitis to prevent peritonitis and adverse outcomes in PD patients.Calprotectin is a 36.5 kD weight, heterocomplex, calcium, and zinc-binding protein secreted from neutrophils, monocytes, epithelial

Assessment of Some Bone Turnover in Chronic Kidney Disease Patients in Tikrit/Iraq

“…The first report to assess peritoneal calprotectin in patients with peritonitis was by Sevik et al (2022) who exhibited that the peritoneal calprotectin increased (44). While the study by Heller et al (2011) showed that urinary calprotectin was 60.7 times higher in intrinsic Acute Kidney Injury (45).…”