Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2013, vol. 22, nr 1, January-February, p. 77–83

Publication type: original article

Language: English

Solute Transport at the Start of Peritoneal Dialysis and the Risk of Peritonitis

Transport otrzewnowy podczas rozpoczęcia leczenia dializą otrzewnową a ryzyko wystąpienia zapalenia otrzewnej

Edyta Gołembiewska1,A,B,C,D,F, Krzysztof Safranow2,C,E,F, Joanna Kabat-Koperska1,B,E,F, Kazimierz Ciechanowski1,C,E,F, Maciej Romanowski3,B,E,F

1 Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland

2 Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland

3 Department of General Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland

Abstract

Background. In peritoneal dialysis (PD) approximately 40% of ultrafiltration (UF) during hypertonic dwell (miniPET test) occurs as free water transport (FWT) through water channels, mainly aquaporin-1. Experimental studies have shown that aquaporin-1 plays a role in cell migration and inflammatory response.
Objectives. The purpose of the study was to evaluate if FWT is associated with the incidence of PD-related peritonitis.
Material and Methods. Standard PET and mini-PET tests were performed on 27 patients at the onset of PD. Clinical data was reviewed and PET transport parameters calculated. The peritonitis rate was assessed and the group of patients was divided into the subgroups of peritonitis-free patients (n = 18) and patients with peritonitis episode (n = 9).
Results. Solute transport, measured as D/P creatinine during the PET test was significantly higher in the group of patients with peritonitis episode than in the group of peritonitis-free patients (0.77 ± 0.12 vs. 0.66 ± 0.11, p = 0.02). In the mini-PET test, there was a tendency to have higher solute transport in the group of patients with peritonitis episode compared to the group of peritonitis-free patients (0.61 ± 0.13 vs. 0.51 ± 0.1, p = 0.07). Ultrafiltration (mL) in the mini-PET test was slightly higher in the group of peritonitis-free patients (642 ± 178 vs. 488.9 ± 161.6, p = 0.06). FWT was not different between the two groups.
Conclusion. Higher solute transport at the start of PD may be associated with the risk of peritonitis.

Streszczenie

Wprowadzenie.W dializie otrzewnowej (DO) około 40% uzyskiwanej ultrafiltracji w czasie wymiany z hipertonicznym roztworem glukozy (test mini-PET) odbywa się na drodze transportu wolnej wody przez kanały wodne, głównie akwaporynę 1. W badaniach doświadczalnych wykazano, że akwaporyna-1 odgrywa również rolę w migracji komórek i odpowiedzi na stan zapalny.
Cel pracy. Ocena, czy wielkość transportu wolnej wody jest związana z częstością występowania zależnego od dializy zapalenia otrzewnej.
Materiał i metody. Standardowy test PET oraz mini-PET wykonano u 27 pacjentów rozpoczynających leczenie nerkozastępcze metodą dializy otrzewnowej. Zanalizowano dane kliniczne oraz parametry transportu w obu testach. Obliczono częstość występowania zapalenia otrzewnej, a grupę pacjentów podzielono na podgrupę pacjentów, u których nie obserwowano zapaleń otrzewnej (n = 18) i podgrupę pacjentów z zapaleniem otrzewnej (n = 9).
Wyniki. Transport, mierzony jako stosunek D/P dla kreatyniny w teście PET był znacząco większy w podgrupie pacjentów z zapaleniem otrzewnej niż w podgrupie pacjentów bez zapalenia (0,77 ± 0,12 vs 0,66 ± 0,11, p = 0,02). W teście mini-PET stwierdzono tendencję do wyższych wartości transportu otrzewnowego w podgrupie pacjentów z zapaleniem otrzewnej w porównaniu do podgrupy pacjentów bez zapalenia (0,61 ± 0,13 vs 0,51 ± 0,1, p = 0,07). Ultrafiltracja (mL) w teście mini-PET była nieco większa w podgrupie pacjentów bez zapalenia otrzewnej (642 ± 178 vs 488,9 ± 161,6, p = 0,06). Transport wolnej wody nie różnił się znacząco między dwoma podgrupami.
Wnioski. Większy transport otrzewnowy u pacjentów rozpoczynających dializoterapię otrzewnową może wiązać się z większym ryzykiem wystąpienia zapalenia otrzewnej.

Key words

aquaporin-1, free water transport, peritoneal dialysis, peritonitis, solute transport.

Słowa kluczowe

akwaporyna-1, transport wolnej wody, dializa otrzewnowa, zapalenie otrzewnej, transport otrzewnowy.

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