Abstract: SA-PO938
Longitudinal Changes of NF-kB Downstream Mediators and Peritoneal Transport Characteristics in New Peritoneal Dialysis Patients
Session Information
- Dialysis: Peritoneal Dialysis - III
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Fung, Winston Ws, Prince of Wales Hospital, Hong Kong, China
- Szeto, Cheuk-Chun, The Chinese University of Hong Kong, Shatin, Hong kong, China
Background
The success of peritoneal dialysis (PD) depends on the semi-permeable peritoneal membrane. The regulation of peritoneal transport remained to be fully elucidated, but intra-peritoneal cytokines, notably interleukin-6 (IL-6), cyclo-oxygenase-2 (COX-2), and hepatocyte growth factor (HGF), probably play important roles. We investigate the relation between longitudinal changes in PD effluent cytokine levels and the corresponding alterations in peritoneal transport parameters over 1 year.
Methods
We studied 46 new PD patients who had peritoneal equilibration test performed at baseline and then one year later. Dialysate-to-plasma creatinine level at 4 hours (D/P4), mass transfer area coefficient of creatinine (MTAC), and ultrafiltration (UF) volume were taken as peritoneal transport parameters. Concomitant PD effluent levels of IL-6, COX-2 and HGF were measured and compared.
Results
There were significant correlations between baseline as well as one-year PD effluent IL-6 and COX-2 levels with the corresponding D/P4 and MTAC. The change in PD effluent IL-6 and COX-2 levels from baseline to one year also correlated with the change in D/P4 and MTAC during the same time. In contrast, PD effluent HGF did not showed any significant correlation with the corresponding D/P4 and MTAC, both at baseline and one year later. After one year, patients who had peritonitis had higher PD effluent IL-6 (26.6 ± 17.4 vs 15.1 ± 12.3 pg/ml, p = 0.037) and COX-2 levels (4.97 ± 6.25 vs 1.60 ± 1.53 ng/ml, p = 0.007) than those without peritonitis, and the number of peritonitis episode during follow up period significantly correlated with the PD effluent IL-6 and COX-2 levels after one year. No significant difference in PD effluent HGF level after 1 year of dialysis are noted between patient with and without peritonitis. There was no significant difference in any cytokine level between patients who received conventional and low glucose degradation product PD solutions.
Conclusion
PD effluent IL-6 and COX-2 levels significantly correlate with the peritoneal transport characteristics. Patients who had peritonitis during the follow up period had higher PD effluent IL-6 and COX-2 levels after one year than patients without peritonitis. Our result suggests that intra-peritoneal IL-6 and COX-2 play important roles in the short-term regulation of peritoneal transport.
Funding
- Government Support - Non-U.S.