Vascular Endothelial Cell Injury Is an Important Factor in the Development of Encapsulating Peritoneal Sclerosis in Long-Term Peritoneal Dialysis PatientsReportar como inadecuado




Vascular Endothelial Cell Injury Is an Important Factor in the Development of Encapsulating Peritoneal Sclerosis in Long-Term Peritoneal Dialysis Patients - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Background and Objectives

Encapsulating peritoneal sclerosis EPS is a rare but serious and life-threatening complication of peritoneal dialysis PD. However, the precise pathogenesis remains unclear; in addition, predictors and early diagnostic biomarkers for EPS have not yet to be established.

Methods

Eighty-three peritoneal membrane samples taken at catheter removal were examined to identify pathological characteristics of chronic peritoneal deterioration, which promotes EPS in patients undergoing long-term PD treatment with low occurrence of peritonitis.

Results

According to univariable logistic regression analysis of the pathological findings, thickness of the peritoneal membrane P = 0.045, new membrane formation score P = 0.006, ratio of luminal diameter to vessel diameter L-V ratio, P<0.001, presence of CD31-negative vessels P = 0.021, fibrin deposition P<0.001, and collagen volume fraction P = 0.018 were associated with EPS development. In analyses of samples with and without EPS matched for PD treatment period, non-diabetes, and PD solution, univariable analysis identified L-V ratio per 0.1 increase: odds ratio OR 0.44, P = 0.003 and fibrin deposition OR 6.35, P = 0.027 as the factors associated with EPS. L-V ratio was lower in patients with fibrin exudation than in patients without fibrin exudation.

Conclusions

These findings suggest that damage to vascular endothelial cells, as represented by low L-V ratio, could be a predictive finding for the development of EPS, particularly in long-term PD patients unaffected by peritonitis.



Autor: Mitsuhiro Tawada, Yasuhiko Ito , Chieko Hamada, Kazuho Honda, Masashi Mizuno, Yasuhiro Suzuki, Fumiko Sakata, Takeshi Terabayashi

Fuente: http://plos.srce.hr/



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