Neutral pH and low-glucose degradation product dialysis fluids induce major early alterations of the peritoneal membrane in children on peritoneal dialysis

Kidney International
Betti SchaeferClaus Peter Schmitt

Abstract

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 f...Continue Reading

Citations

Nov 23, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Keia R Sanderson, Bradley A Warady
Nov 2, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Uwe Querfeld, Franz Schaefer
May 28, 2019·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Michael BoehmAndreas Vychytil
Apr 14, 2020·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Ayman Karkar
Nov 21, 2019·International Journal of Molecular Sciences·Rajesh M JagirdarVassilios Liakopoulos
Feb 1, 2019·Frontiers in Physiology·Maria Bartosova, Claus Peter Schmitt
Feb 18, 2020·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Pauline BorceuxEric Goffin
Aug 6, 2020·International Journal of Molecular Sciences·Mario BonominiArduino Arduini
Dec 31, 2020·International Journal of Molecular Sciences·Francesca PiccapaneGiuseppe Procino
Sep 30, 2020·Biomolecules·Vanessa MarchantMarta Ruiz-Ortega
Apr 16, 2021·Frontiers in Immunology·Michela TerriRaffaele Strippoli
Jul 15, 2021·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Alena ParikovaRaymond T Krediet
Jul 9, 2021·Circulation Research·Maria BartosovaClaus Peter Schmitt
Aug 8, 2021·International Journal of Molecular Sciences·Mario BonominiGiovanni Gambaro
May 18, 2021·Clinical and Experimental Nephrology·Naoya SugiyamaYasuhiko Ito
Aug 27, 2021·Science Translational Medicine·Rebecca HerzogKlaus Kratochwill

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