Neutral pH and low–glucose degradation product dialysis fluids induce major early alterations of the peritoneal membrane in children on peritoneal dialysis
| Autor: | Ariane Zaloszyc, Anette Melk, Dorota Drozdz, Uwe Querfeld, Felix Lasitschka, Bradley A. Warady, Maria Bartosova, Yok Chin Yap, Anne K Mühlig, Franz Schaefer, Salim Caliskan, Enrico Verrina, Sara Testa, Raj Bhayadia, Klaus Arbeiter, Gema Ariceta, Akos Ujszaszi, Sahar Fathallah-Shaykh, Johan VandeWalle, Péter Vörös, Aysun Karabay Bayazit, Karel Vondrak, Bruno Ranchin, Rafael T. Krmar, Rimante Cerkauskiene, Philipp Romero, Peter Sallay, Stephan Macher-Goeppinger, Christina Taylan, Rainer Büscher, Betti Schaefer, Günter Klaus, Claus Peter Schmitt |
|---|---|
| Přispěvatelé: | Çukurova Üniversitesi |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Pathology medicine.medical_specialty Epithelial-Mesenchymal Transition Adolescent medicine.medical_treatment Biopsy 030232 urology & nephrology Medizin Peritonitis 030204 cardiovascular system & hematology peritoneal membrane Peritoneal dialysis 03 medical and health sciences 0302 clinical medicine Peritoneum Fibrosis Dialysis Solutions medicine Lymphatic vessel Humans Child Dialysis Catheter insertion Chemistry Infant Hydrogen-Ion Concentration medicine.disease medicine.anatomical_structure Glucose Treatment Outcome peritoneal dialysis Nephrology Case-Control Studies Child Preschool Kidney Failure Chronic Female chronic kidney disease Kidney disease |
| Popis: | WOS: 000439138700024 PubMed ID: 29776755 The effect of peritoneal dialysates with low-glucose degradation products on peritoneal membrane morphology is largely unknown, with functional relevancy predominantly derived from experimental studies. To investigate this, we performed automated quantitative histomorphometry and molecular analyses on 256 standardized peritoneal and 172 omental specimens from 56 children with normal renal function, 90 children with end-stage kidney disease at time of catheter insertion, and 82 children undergoing peritoneal dialysis using dialysates with low-glucose degradation products. Follow-up biopsies were obtained from 24 children after a median peritoneal dialysis of 13 months. Prior to dialysis, mild parietal peritoneal inflammation, epithelial-mesenchymal transition and vasculopathy were present. After up to six and 12 months of peritoneal dialysis, blood microvessel density was 110 and 93% higher, endothelial surface area per peritoneal volume 137 and 95% greater, and submesothelial thickness 23 and 58% greater, respectively. Subsequent peritoneal changes were less pronounced. Mesothelial cell coverage was lower and vasculopathy advanced, whereas lymphatic vessel density was unchanged. Morphological changes were accompanied by early fibroblast activation, leukocyte and macrophage infiltration, diffuse podoplanin presence, epithelial mesenchymal transdifferentiation, and by increased proangiogenic and profibrotic cytokine abundance. These transformative changes were confirmed by intraindividual comparisons. Peritoneal microvascular density correlated with peritoneal small-molecular transport function by uni- and multivariate analysis. Thus, in children on peritoneal dialysis neutral pH dialysates containing low-glucose degradation products induce early peritoneal inflammation, fibroblast activation, epithelial-mesenchymal transition and marked angiogenesis, which determines the PD membrane transport function. European Training and Research in Peritoneal Dialysis (EuTRiPD) Programme - European Union within the Marie Curie Scheme [287813]; Medical Faculty of the University of Heidelberg; Fresenius Medical Care (Bad Homburg, Germany); ERA-EDTA; KfH Foundation for Preventive Medicine; Baxter; Fresenius Medical Care MB was supported by the European Training and Research in Peritoneal Dialysis (EuTRiPD) Programme, a project funded by the European Union within the Marie Curie Scheme (287813). BS was supported by the Medical Faculty of the University of Heidelberg. Further support was received from Fresenius Medical Care (Bad Homburg, Germany), ERA-EDTA, and the KfH Foundation for Preventive Medicine. FS, BAW, and CPS obtained further research funding from Baxter and Fresenius Medical Care. We are grateful to Dr. E. Herpel and Mr. J. Moyers from Tissue Bank of the National Center for Tumor Diseases (NCT, Heidelberg, Germany) and Institute of Pathology (Heidelberg University Hospital) for technical assistance. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|