Literature DB >> 23718260

Inflammatory factors for hypoalbuminemia in Japanese peritoneal dialysis patients.

Masuyo Shioya1, Takuya Yoshida, Kenji Kasai, Ryuichi Furuya, Akihiko Kato, Noriko Mori, Yoshihiro Matsumoto, Hiromichi Kumagai.   

Abstract

AIM: Hypoalbuminaemia is a common complication of peritoneal dialysis (PD), and the leakage of albumin through peritoneal membrane may be a principal reason for hypoalbuminaemia. However, the relationship between peritoneal inflammation, peritoneal transport properties and hypoalbuminaemia has not been fully elucidated.
METHODS: A cross-sectional study was performed on 76 Japanese PD patients who had been using a low-glucose PD solution and icodextrin. Systemic inflammatory markers of C-reactive protein (CRP) and serum interleukin-6 (IL-6), peritoneal effluent markers of dialysate IL-6 and CA125, the dialysate-to-plasma ratio of creatinine (D/Pcr) and the dialysate protein concentration were measured and examined for their relationship with hypoalbuminaemia.
RESULTS: There was a significant positive correlation between serum IL-6 and dialysate IL-6, mean dialysate IL-6 being significantly higher than mean serum IL-6, suggesting that intraperitoneal inflammation was a principal origin of systemic inflammation. Both serum and dialysate IL-6 were significantly correlated with serum albumin (r= -0.25, P<0.05 and r=-0.32, P<0.01, respectively). Dialysate IL-6 was significantly correlated with D/Pcr and the dialysate protein concentration, and there was a significantly positive association between D/Pcr and the dialysate protein concentration. Dialysate CA125, which is argued to be a marker of mesothelial cell mass in this study, was positively correlated with D/Pcr and the dialysate protein concentration. The dialysate protein, dialysate IL-6 and dialysate CA125 all increased according to the peritoneal transport rate defined by D/Pcr. A multiple-regression analysis showed that serum albumin was independently associated with the age, D/Pcr and serum IL-6.
CONCLUSION: Hypoalbuminaemia was attributable to both the increased peritoneal permeability and systemic inflammation, and intraperitoneal inflammation might contribute to developing these complications.
© 2013 The Authors. Nephrology © 2013 Asian Pacific Society of Nephrology.

Entities:  

Keywords:  CA125; dialysate; hypoalbuminaemia; inflammation; interleukin-6

Mesh:

Substances:

Year:  2013        PMID: 23718260     DOI: 10.1111/nep.12106

Source DB:  PubMed          Journal:  Nephrology (Carlton)        ISSN: 1320-5358            Impact factor:   2.506


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