Proteomic Research in Peritoneal Dialysis

Abstract

Peritoneal dialysis (PD) is an established home care, cost-effective renal replacement therapy (RRT), which offers several advantages over the most used dialysis modality, hemodialysis. Despite its potential benefits, however, PD is an under-prescribed method of treating uremic patients. Infectious complications (primarily peritonitis) and bio-incompatibility of PD solutions are the main contributors to PD drop-out, due to their potential for altering the functional and anatomical integrity of the peritoneal membrane. To improve the clinical outcome of PD, there is a need for biomarkers to identify patients at risk of PD-related complications and to guide personalized interventions. Several recent studies have shown that proteomic investigation may be a powerful tool in the prediction, early diagnosis, prognostic assessment, and therapeutic monitoring of patients on PD. Indeed, analysis of the proteome present in PD effluent has uncovered several proteins involved in inflammation and pro-fibrotic insult, in encapsulating peritoneal sclerosis, or even in detecting early changes before any measurable modifications occur in the traditional clinical parameters used to evaluate PD efficacy. We here review the proteomic studies conducted thus far, addressing the potential use of such omics methodology in identifying potential new biomarkers of the peritoneal membrane welfare in relation to dialytic prescription and adequacy.

Optical Chemical Sensor Based on Fast-Protein Liquid Chromatography for Regular Peritoneal Protein Loss Assessment in End-Stage Renal Disease Patients on Continuous Ambulatory Peritoneal Dialysis

“…It is reasonable to propose that the sensor can determine the total protein concentration in biological fluids, but for each type of sample, separate calibration should be performed because of the possibly different protein compositions. The most abundant protein in the peritoneal dialysate is albumin [52], and BSA solutions were used as the most convenient and affordable medium for calibration in the current research (Section 3.1). Undoubtedly, calibration using several different proteins, e.g., albumin and immunoglobulins, is preferable and would be performed in the future.…”

Proteomics and Extracellular Vesicles as Novel Biomarker Sources in Peritoneal Dialysis in Children

“…They found that specific glycosylation traits significantly correlate to D/P creatinine at PET and that the same traits were associated with TGF-β1 and VEGF. However, despite the increasing number of proteomics studies on the adult dialysis patient population, it is not yet possible to identify a statistically robust clinical biomarker [ 51 ]. Parallel to this area and in the light of the presenting background, pediatric studies have been developed.…”

How to Improve the Biocompatibility of Peritoneal Dialysis Solutions (without Jeopardizing the Patient’s Health)

“…In this regard, and in a broader sense to improve the clinical outcomes of PD, it is necessary to identify new biomarkers of the health of the peritoneal membrane in relation to dialytic prescription as tools in guiding personalized interventions in patients who are at risk of PD-related complications [ 102 ]. Proteomic analysis of PD dialysate might help to identify biomolecules that are indicative of the peritoneal health, peritoneal transport status, and ongoing pathological processes [ 103 ].…”