The Peritoneal Membrane—A Potential Mediator of Fibrosis and Inflammation among Heart Failure Patients on Peritoneal Dialysis

Kunin, Margarita; Beckerman, Pazit

doi:10.3390/membranes12030318

Cited by 7 publications

(5 citation statements)

References 90 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While the integrity of the membrane has a central role for long‐term success of PD 3,4 the evidence on the membrane status before PD, as herein provided, can barely be found in literature 12,13,20 . On the other hand, these are stage 5 chronic kidney disease patients, that is, uraemic patients.…”

Section: Discussionmentioning

confidence: 87%

“…In addition, the risks related to vascular access are avoided, while the hospitalization rates, the functional status and the quality of life are improved, maintaining similar survival rates. [1][2][3][4][5] Furthermore, PD is easier to use, has less need for expert medical staff and technical support and is accessible in remote geographical locations. PD gives patients more flexibility, allowing them to continue working.…”

Section: Introductionmentioning

confidence: 99%

“…When compared with haemodialysis (HD), PD is more cost‐effective, it allows better preservation of residual kidney function and it has less impact on haemodynamics. In addition, the risks related to vascular access are avoided, while the hospitalization rates, the functional status and the quality of life are improved, maintaining similar survival rates 1–5 . Furthermore, PD is easier to use, has less need for expert medical staff and technical support and is accessible in remote geographical locations.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Alpha‐klotho and peritoneal membrane status: A hypothesis generating study

Branco

Martins

Calça

et al. 2022

Eur J Clin Investigation

View full text Add to dashboard Cite

Background Long‐term success of peritoneal dialysis relies on the integrity of the peritoneal membrane. This proof‐of‐concept study addressed the hypothesis that fibrosis is already present in the membrane at pre‐dialysis and that the membrane status is related to the individual's uraemic fingerprint. Methods A clinical‐mechanistic, transversal, single‐centre study was conducted. Pre‐dialysis peritoneal biopsies were scored considering the submesothelial compact zone thickness (STM), vasculopathy and inflammation. We investigated if the membrane status could be inferred from a panel of proteins (α‐Klotho, Galectin‐3, FGF21, FGF23, Tweak, TNFα and hsPCR) in blood. Results A total 58 incident patients aged 56 ± 15 years old were included, 31% female, 55% hypertension, 29% diabetic and 24% obese. Person‐to‐person STM was found to be highly variable and 38% of patients were fibrosis positive. Both α‐Klotho (Spearman r = −.7491, p < 0.001) and FGF21 (Spearman r = −.5102, p < 0.001) were negatively associated with STM. α‐Klotho, but not FGF21, was able to discriminate fibrosis from nonfibrosis with/without inflammation and vasculopathy. PLS models identified α‐Klotho as the protein most relevant for fibrosis. α‐Klotho was independently associated with fibrosis of the peritoneal membrane (OR = .991 (.896–.997), p = 0.002). Conclusion Before the start of dialysis in incident patients, some patients already present fibrosis of the peritoneal membrane and other patients do not. Our findings suggest that α‐Klotho may be implicated in fibrosis of the peritoneal membrane.

show abstract

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Alpha‐klotho and peritoneal membrane status: A hypothesis generating study

Branco

Martins

Calça

et al. 2022

Eur J Clin Investigation

View full text Add to dashboard Cite

show abstract

“…Inflammation is believed to be the primary mechanism underlying CV events in patients with renal insufficiency [ 83 , 84 , 85 ]. A micro-inflammatory state refers to the process where toxins stimulate the production of various inflammatory factors, which persist in the blood, causing mild inflammation.…”

Section: Risk Factor Management Of Hf In Dialysis Patientsmentioning

confidence: 99%

Management of Chronic Heart Failure in Dialysis Patients: A Challenging but Rewarding Path

Guo,

Ji,

Sun

et al. 2024

Rev. Cardiovasc. Med.

View full text Add to dashboard Cite

Chronic heart failure (CHF) is a common complication and cause of death in dialysis patients. Although several clinical guidelines and expert consensus on heart failure (HF) in the general population have been issued in China and abroad, due to abnormal renal function or even no residual renal function (RRF) in dialysis patients, the high number of chronic complications, as well as the specificity, variability, and limitations of hemodialysis (HD) and peritoneal dialysis (PD) treatments, there are significant differences between dialysis patients and the general population in terms of the treatment and management of HF. The current studies are not relevant to all dialysis-combined HF populations, and there is an urgent need for high-quality studies on managing HF in dialysis patients to guide and standardize treatment. After reviewing the existing guidelines and literature, we focused on the staging and diagnosis of HF, management of risk factors, pharmacotherapy, and dialysis treatment in patients on dialysis. Based on evidence-based medicine and clinical trial data, this report reflects new perspectives and future trends in the diagnosis and treatment of HF in dialysis patients, which will further enhance the clinicians’ understanding of HF in dialysis patients.

show abstract

“…It consists of the mesothelial cell monolayer lining the basal membrane together with the fibrous submesothelium, which contains blood and lymphatic vessels and nerves. The peritoneum provides nutrition and mechanical support to abdominal organs, protects from frictions and adhesions and regulates local homeostasis including inflammatory, fibrotic and angiogenic processes and exchanges abdominal fluids 2 . It is involved in internal organ development through biochemical cues that drive and sustain cell transition 3 , 4 and regulates pathophysiological processes such as peritoneal tumor progression and post-infectious and post-interventional adhesions 5 .…”

Section: Introductionmentioning

confidence: 99%

Human peritoneal tight junction, transporter and channel expression in health and kidney failure, and associated solute transport

Levai,

Marinovic,

Bartosova

et al. 2023

Sci Rep

View full text Add to dashboard Cite

Next to the skin, the peritoneum is the largest human organ, essentially involved in abdominal health and disease states, but information on peritoneal paracellular tight junctions and transcellular channels and transporters relative to peritoneal transmembrane transport is scant. We studied their peritoneal localization and quantity by immunohistochemistry and confocal microscopy in health, in chronic kidney disease (CKD) and on peritoneal dialysis (PD), with the latter allowing for functional characterizations, in a total of 93 individuals (0–75 years). Claudin-1 to -5, and -15, zonula occludens-1, occludin and tricellulin, SGLT1, PiT1/SLC20A1 and ENaC were consistently detected in mesothelial and arteriolar endothelial cells, with age dependent differences for mesothelial claudin-1 and arteriolar claudin-2/3. In CKD mesothelial claudin-1 and arteriolar claudin-2 and -3 were more abundant. Peritonea from PD patients exhibited increased mesothelial and arteriolar claudin-1 and mesothelial claudin-2 abundance and reduced mesothelial and arteriolar claudin-3 and arteriolar ENaC. Transperitoneal creatinine and glucose transport correlated with pore forming arteriolar claudin-2 and mesothelial claudin-4/-15, and creatinine transport with mesothelial sodium/phosphate cotransporter PiT1/SLC20A1. In multivariable analysis, claudin-2 independently predicted the peritoneal transport rates. In conclusion, tight junction, transcellular transporter and channel proteins are consistently expressed in peritoneal mesothelial and endothelial cells with minor variations across age groups, specific modifications by CKD and PD and distinct associations with transperitoneal creatinine and glucose transport rates. The latter deserve experimental studies to demonstrate mechanistic links.Clinical Trial registration: The study was performed according to the Declaration of Helsinki and is registered at www.clinicaltrials.gov (NCT01893710).

show abstract

The Peritoneal Membrane—A Potential Mediator of Fibrosis and Inflammation among Heart Failure Patients on Peritoneal Dialysis

Cited by 7 publications

References 90 publications

Alpha‐klotho and peritoneal membrane status: A hypothesis generating study

Alpha‐klotho and peritoneal membrane status: A hypothesis generating study

Management of Chronic Heart Failure in Dialysis Patients: A Challenging but Rewarding Path

Human peritoneal tight junction, transporter and channel expression in health and kidney failure, and associated solute transport

Contact Info

Product

Resources

About