Relationship between peritoneal permeability with inflammation and subclinical atherosclerosis in peritoneal dialysis patients

Abstract

Aim: High permeability in peritoneal dialysis (PD) is reported to be associated with increased mortality. Cardiovascular disease is the most important cause of morbidity and mortality in patients with end-stage renal disease. The inflammation is thought to take part in development of atherosclerosis. The aim of this study is to investigate the relation of peritoneal permeability type with carotid intima media thickness (CIMT) in PD patients. Material and Methods: Based on the standard peritoneal equilibration test, 56 PD patients (28 male) were divided in two transporter groups: low (low+low average) and high (high+high average) permeability. C-reactive protein (CRP) measured as a marker of inflammation and CIMT was evaluated by high-resolution B-mode ultrasonography. Results: Twenty one patients were low and 35 of them were high peritoneal transporters. Mean CRP level was significantly higher in the high permeability group (HPG) (1.62±1.7 vs 0.84±1 mg/dL; p=0.006). CIMT was higher in the HPG but this difference did not reach statistical significance (0.810±0.160 vs 0.740±0.160 mm; p=0.16). Conclusions: CRP, an indicator of inflammation, was found to be higher in the HPG. CIMT also was found to be higher in HPG although it was not statistically significant. One of the causes of increased mortality rate in this group of patients may be explained by inflammation and atherosclerosis.

CA-125 and CCL2 may indicate inflammation in peritoneal dialysis patients

“…The Cancer Antigen 125 (CA-125) in serum is traditionally known as a tumor marker in ovarian cancer. Because it is also produced by the mesothelial cells of the peritoneum and is unable to overcome the pores of the peritoneal membrane due to its high molecular weight (>200 kD), CA-125 has been proposed as an alternative for assessing the integrity of peritoneal membrane 8 , 9 . A cohort study developed by Otoni et al (2000) 10 , with 15 patients at the beginning of PD, showed a significant reduction in the levels of CA-125 in the dialysate after about 60 days of follow-up (22.0 U/mL ± 4.5 vs 4.8 U/mL ± 1.3).…”