scholarly journals Long-Term Peritoneal Dialysis Treatment Provokes Activation of Genes Related to Adaptive Immunity

2019 ◽  
pp. 775-783
Author(s):  
A. PARIKOVA ◽  
P. HRUBA ◽  
R. KREDIET ◽  
Z. KREJCIK ◽  
V. STRANECKY ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Adaptive Immunity ◽  
Interleukin 2 ◽  
Tumor Necrosis Factor Receptor ◽  
Dialysis Treatment ◽  
T Helper 2 ◽  
Expression Of Genes ◽  
Cell Adhesion Molecule 1 ◽  
Peritoneal Function

Permanent irritation of the peritoneum during peritoneal dialysis (PD) treatment leads to local chronic inflammation and subsequently activation of processes driving fibrogenesis in the long-term. The aim of the study was to compare the peritoneal effluent transcriptome of 20 patients treated less and 13 patients treated more than 2 years using microarray analysis. An increased expression of genes associated with an immune response was observed in long-term treated patients with well preserved peritoneal function, when compared to patients treated less than 2 years. From 100 genes highly expressed in long-term patients, a significant up-regulation of six was found by RT-qPCR: LY9 (lymphocyte antigen 9), TNSFR4 (tumor necrosis factor receptor superfamily, member 4), CD 79A (CD79a molecule), CCR7 (chemokine C-C receptor 7), CEACAM1 (carcinoembryonic antigen-related cell adhesion molecule 1) and IL2RA (interleukin 2 receptor alpha chain). Furthermore, the effluent cell population was analysed. A positive relationship between the number of granulocytes and NK cells on one hand, and duration of PD treatment on the other, was shown. We conclude, that the mechanisms of adaptive immunity promoting T helper 2 cells response are activated in the long-term before functional alterations develop. It consequently might trigger the fibrosis promoting processes.

Long-Term Clinical Experience with Pure Bicarbonate Peritoneal Dialysis Solutions

2006 ◽  
Vol 26 (1) ◽  
pp. 89-94 ◽  
Author(s):  
Jesús Montenegro ◽  
Ramón M. Saracho ◽  
Isabel M. Martínez ◽  
Rosa I. Muñoz ◽  
Julian J. Ocharan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Base Excess ◽  
Descriptive Analysis ◽  
Residual Renal Function ◽  
Dialysis Treatment ◽  
Treatment Groups ◽  
Calcium Phosphorus ◽  
Acid Base Status ◽  
Student’S T

Objectives The aim of this prospective study was to collect long-term experience in incident peritoneal dialysis (PD) patients treated with pure bicarbonate-buffered PD fluids. Methods The metabolic parameters acidosis, acid–base status, adequacy, fluid balance, nutritional markers, calcium, phosphorus, parathyroid hormone (PTH), and general laboratory work and medication were compared between incident PD patients in two groups: one treated with a 34 mmol/L bicarbonate-buffered PD fluid (BIC), the other with a 35 mmol/L lactate-buffered PD fluid (LAC). The observation period included 5 visits from 1 month (visit 1) until 12 months (visit 5) after the start of dialysis treatment. For the descriptive analysis, means and standard deviations were calculated. Student's t-test and linear mixed models were used to compare the two treatment groups. Results 36 patients were followed for 12 months, 18 in the BIC group and 18 in the LAC group. Statistically significant differences between the groups (at the end of study) were found. In BIC group, venous plasma bicarbonate was 27.4 ± 2.3 mmol/L, base excess 0.8 ± 2.2 mmol/L, and pH 7.31 ± 0.05; in LAC group, venous bicarbonate was 25.9 ± 2.4 mmol/L, base excess –0.6 ± 2.1 mmol/L, and pH 7.30 ± 0.04. No patient from the BIC group needed oral bicarbonate, in contrast to 4 patients in the LAC group. Whereas peritoneal urea and creatinine clearances did not differ between the groups, there was better renal solute clearance in the BIC group, accompanied by better-preserved diuresis at 12 months (1333 ± 935 mL with BIC vs 839 ± 556 mL with LAC). The reverse was true for ultrafiltration. Conclusions Pure bicarbonate-buffered PD solutions were superior in correcting metabolic acidosis and they allowed omission of oral bicarbonate. The minor ultrafiltration with bicarbonate-buffered PD solutions was counterbalanced by better-preserved residual renal function with these solutions.

scholarly journals Feasibility of Resuming Peritoneal Dialysis after Severe Peritonitis and Tenckhoff Catheter Removal

2002 ◽  
Vol 13 (4) ◽  
pp. 1040-1045
Author(s):  
Cheuk-Chun Szeto ◽  
Kai-Ming Chow ◽  
Teresa Yuk-Hwa Wong ◽  
Chi-Bon Leung ◽  
Angela Yee-Moon Wang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Catheter Removal ◽  
Early Assessment ◽  
Dialysis Adequacy ◽  
Technique Survival ◽  
Tenckhoff Catheter ◽  
Success Group ◽  
Severe Peritonitis ◽  
Peritoneal Function

ABSTRACT. Published guidelines suggest that after an episode of severe peritonitis that requires Tenckhoff catheter removal, peritoneal dialysis can be resumed after a minimum of 3 wk. However, the feasibility of resuming peritoneal dialysis after Tenckhoff catheter removal remains unknown. One hundred patients were identified with peritonitis that did not respond to standard antibiotic therapy in a specific center. Their clinical course was reviewed; in all of them, Tenckhoff catheters were removed and reinsertion was attempted at least 4 wk later. In 51 patients, the Tenckhoff catheter was successfully reinserted and peritoneal dialysis was resumed (success group). In the other 49 pateints, reinsertion failed and the patient was put on long-term hemodialysis (fail group). The patients were followed for 18.5 ± 16.8 mo. The overall technique survival was 30.8% at 24 mo. In the success group, 11 patients were changed to long-term hemodialysis within 8 mo after their return to continuous ambulatory peritoneal dialysis. In the fail group, 18 of the 20 deaths occurred within 12 mo after conversion to long-term hemodialysis. After resuming peritoneal dialysis, there was a significant decline in net ultrafiltration volume (0.38 ± 0.16 to 0.21 ± 0.19 L; P = 0.03) and a trend of rise in dialysate-to-plasma ratios of creatinine at 4 h (0.664 ± 0.095 to 0.725 ± 0.095; P = 0.15). Forty-five patients (88.2%) required additional dialysis exchanges or hypertonic dialysate to compensate for the loss of solute clearance or ultrafiltration, although there was no significant change in dialysis adequacy or nutritional status. It was concluded that after an episode of severe peritonitis that required Tenckhoff catheter removal, only a small group of patients could return to peritoneal dialysis. An early assessment of peritoneal function after Tenckhoff catheter reinsertion may be valuable.

Is Encapsulating Peritoneal Sclerosis a Threatening Issue in Continuous Ambulatory Peritoneal Dialysis? The Japanese Experience

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 132-133 ◽  
Author(s):  
Masaaki Nakayama ◽  
Masato Ikeda ◽  
Naohiko Katoh ◽  
Keitaro Yokoyama ◽  
Hiroyasu Yamamoto ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Preventive Measures ◽  
Japanese Patients ◽  
Surgical Approaches ◽  
Success Rates ◽  
Dialysis Therapy ◽  
Dialysis Treatment ◽  
Treatment Alternatives

Encapsulating peritoneal sclerosis (EPS) is undoubtedly the most serious complication of continuous ambulatory peritoneal dialysis treatment in Japan, with a mortality rate ranging from about 39% to 49% in reported series. Cases of EPS have been linked to long-term peritoneal dialysis, and limitations on renal transplantation in Japan mean that most Japanese patients have to accept long-term dialysis therapy, which is a critical problem. Treatment alternatives for EPS include total parenteral nutrition, prednisolone administration, and surgical approaches, all of which have varying success rates. Additional therapeutic and new preventive measures have to be established for EPS.

scholarly journals Prolonged Effect of Seminal Plasma on Global Gene Expression in Porcine Endometrium

Genes ◽  
2020 ◽  
Vol 11 (11) ◽  
pp. 1302
Author(s):  
Marek Bogacki ◽  
Beenu Moza Jalali ◽  
Anna Wieckowska ◽  
Monika M. Kaczmarek
Keyword(s):  
Seminal Plasma ◽  
Interleukin 2 ◽  
Global Gene Expression ◽  
Initial Response ◽  
Interferon Γ ◽  
Long Term Effects ◽  
Cellular Processes ◽  
Expression Of Genes ◽  
Long Term Effect

Seminal plasma (SP) deposited in the porcine uterine tract at the time of mating is known to elicit an initial response that is beneficial for pregnancy outcome. However, whether SP has any long-term effect on alterations in endometrial molecular and cellular processes is not known. In this study, using microarray analyses, differential changes in endometrial transcriptome were evaluated after Day 6 of SP-infusion (6DPI) or Day 6 of pregnancy as compared to corresponding day of estrous cycle. Both, pregnancy and SP induced significant changes in the endometrial transcriptome and most of these changes were specific for a particular group. Functional analysis of differentially expressed genes (DEGs) using Ingenuity Pathway Analysis revealed that inhibition in immune response was affected by both pregnancy and SP infusion. Long-term effects of SP included differential expression of genes involved in inhibition of apoptosis, production of reactive oxygen species and steroid biosynthesis, and activation of processes such as proliferation of connective tissue cells and microvascular endothelial cells. Moreover, interleukin-2 and interferon-γ was identified to be responsible for regulating expression of many DEGs identified on 6DPI. The present study provides evidence for the long-term effects of SP on porcine endometrium that can be beneficial for pregnancy success.

The Plasma Leak–to–Response Hypothesis: A Working Hypothesis on the Pathogenesis of Encapsulating Peritoneal Sclerosis after Long-Term Peritoneal Dialysis Treatment

2005 ◽  
Vol 25 (4_suppl) ◽  
pp. 71-76 ◽  
Author(s):  
Masaaki Nakayama
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Present Article ◽  
Crucial Role ◽  
Dialysis Treatment ◽  
Working Hypothesis ◽  
Primary Mechanism ◽  
Histologic Changes

Encapsulating peritoneal sclerosis (EPS) is one of the most serious complications of long-term peritoneal dialysis (PD). Long-term PD therapy has been suggested as a risk factor for EPS development among patients in Japan and Australia. Although the primary mechanism of EPS development has not been clarified, histologic changes of the peritoneum associated with prolonged PD are postulated to be causally related. The present article proposes a working hypothesis—the plasma leak–to–response hypothesis—that vascular alterations in the peritoneum of long-term PD patients play a crucial role in the initiation and development of EPS.

Standardized Peritoneal Equilibration Test in Japanese Children and the Influence of Long-Term Peritoneal Dialysis

2008 ◽  
Vol 28 (3_suppl) ◽  
pp. 150-152
Author(s):  
Yoshitsugu Kaku ◽  
Masataka Honda
Keyword(s):  
Peritoneal Dialysis ◽  
Study Data ◽  
Regression Equations ◽  
Japanese Children ◽  
Peritoneal Equilibration Test ◽  
Peritoneal Permeability ◽  
Standard Values ◽  
Standardized Method ◽  
Peritoneal Function

⋄ Objective To establish a standardized method and standard values of peritoneal equilibration test (PET) in children and to elucidate the factors influencing peritoneal permeability, we standardized the method of PET in the leading hospitals of the Japanese Study Group of Pediatric Peritoneal Dialysis. ⋄ Methods Using 2.5% glucose dialysate and an infusion volume of 1100 mL/m2 body surface area (BSA), we performed 202 standardized PETs. The patients within 1 month of a peritonitis episode were excluded. ⋄ Results The–1 standard deviation (SD), mean, and +1 SD values of end dialysate–to–initial dialysate ratio of (D/D0) glucose were 0.31, 0.41, and 0.51 respectively. The dialysate-to-plasma ratios (D/P) of creatinine were 0.52, 0.65, and 0.78. These values were similar to those of Twardowski's adult PET, although previous reports about standardized pediatric PET described more permeable values. Because the duration of PD was longer in the study patients, peritoneal permeability was increased significantly in patients with and without experience of peritonitis alike. The slope indices of the regression equations between the duration of PD and peritoneal permeability in the two groups were same. ⋄ Conclusions Standardized PET in Japanese children with 2.5% glucose dialysate and an infusion volume of 1100 mL/m2 BSA produces standard values similar to those of Twardowski's adult PET. This standardized method of PET is suitable for pediatric PD patients, and peritoneal permeability in children is not higher than that in adults. In addition, the study data show that long-term peritoneal dialysis worsens peritoneal function more than experience of peritonitis does.

scholarly journals Long-term sonographic evaluation of the peritoneum in peritoneal dialysis patients: A retrospective cohort study

2020 ◽  
Author(s):  
Shinya Taguchi ◽  
Takayasu Ohtake ◽  
Yasuhiro Mochida ◽  
Kunihiro Ishioka ◽  
Hidekazu Moriya ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Morphological Changes ◽  
Membrane Thickness ◽  
Peritoneal Membrane ◽  
Change Rate ◽  
Peritoneal Permeability ◽  
The Mean ◽  
Peritoneal Function ◽  
Repeated Evaluation

Abstract Background Long-term peritoneal dialysis (PD) causes morphological changes to the peritoneum. However, the sequential morphological changes of the peritoneum remain unclear due to the invasiveness and ethical dilemmas surrounding peritoneal biopsies. We aimed to evaluate these long-term morphological peritoneal changes using sonography, which was recently reported to be useful for morphological peritoneal evaluation. Methods We retrospectively identified 115 PD patients who underwent sonographic peritoneal membrane thickness (PMT) measurement. Univariate and multivariate linear regression analyses identified factors related to PMT at baseline (bPMT), at last measurement (lPMT), and the PMT change rate. Of the 115 patients, 42 patients had at least two PMT measurements, including a bPMT measurement. We evaluated the PMT change between bPMT and lPMT. We also evaluated the annual PMT change for 3 years before PD withdrawal in patients who discontinued PD due to peritoneal dysfunction. Clinical characteristics and parameters were analyzed according to PMT change rates (≤ 0 [n = 28] or > 0 [n = 20]). Results The mean age at PD introduction and mean PD duration were 63.7 ± 12.7 years and 40.5 ± 30.1 months, respectively. There was a significant positive correlation between the dialysate to plasma ratio of creatinine (D/P Cr) and lPMT (r = 0.386, p = 0.004), but not bPMT (r=-0.114, p = 0.326). In the multivariate analyses, D/P Cr remained an independent predictor of lPMT (r = 0.478, p = 0.001) after adjusting for age, sex, body mass index, PD duration, diabetes, and peritonitis rate. The mean bPMT and lPMT were 0.67 ± 0.15 mm and 0.69 ± 0.10 mm, respectively, without statistical difference (p = 0.49). Annual PMTs for 3 years before PD withdrawal were 0.67 ± 0.13 mm, 0.66 ± 0.11 mm, and 0.67 ± 0.08 mm, respectively, with no significant differences among measurements (p = 0.967). There were no differences in PD duration, the use of a dialysate containing over 2.5% glucose or icodextrin, and the peritonitis rate between groups divided by the PMT change rate. Conclusions PMT, measured by sonography, was positively correlated with peritoneal permeability. Repeated evaluation of the peritoneum by sonography will enable the recognition of transition in peritoneal function in real time and allow for more appropriate PD management. Furthermore, the peritoneum was not necessarily thickened regardless of PD duration or cause of withdrawal.

The past and the present of peritoneal dialysis treatment

2008 ◽  
Vol 149 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Kálmán Polner
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Treatment ◽  
The Past

A szerző rövid áttekintést ad a peritonealis dialíziskezelés történetéről, kiemelve két magyar nefrológus, Stephen I. Vas és Taraba István munkásságának jelentőségét. A peritonealis dialíziskezelés fejlődése oda vezetett, hogy mára a hemodialízissel egyenrangú vesepótló kezelés lett. A maradék vesefunkció megőrzésével az első két évben a morbiditási, mortalitási mutatók és a betegek életminősége vonatkozásában felül is múlja azt. Gazdasági szempontból egyértelműen előnyösebb a hemodialízisnél, ezért az egyre több veseelégtelen beteg ellátásában várhatóan még nagyobb szerepet fog kapni. Az utóbbi években a technológia fejlődése és az automata peritonealis dialíziskezelések elterjedése is a minőség javítását segíti. A peritonealis dialíziskezelés a beteg önkezelése révén új kapcsolatrendszert alakít ki a betegek és az egészségügyi személyzet között, fokozódik a betegoktatás igénye, javul a betegek önbecsülése, együttműködése, ami összességében jobb rehabilitációs esélyeket és jobb életminőséget eredményez. A hazai peritonealis dialíziskezelés még elmarad az európai átlagtól, de a fejlődés dinamikus, és várhatóan a betegek száma is tovább fog növekedni.

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