Department of Nephrology and Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nephrol Dial Transplant. 2011 Jul;26(7):2322-32. doi: 10.1093/ndt/gfq702. Epub 2010 Nov 22.
High baseline peritoneal solute transport rate is reportedly associated with reduced patient and technique survival in continuous peritoneal dialysis (PD) patients. However, the determinants of baseline peritoneal solute transport rate remain uncertain. The aim of this study was to investigate the relationship between peritoneal local inflammation, angiogenesis and systemic inflammation and baseline peritoneal permeability.
Peritoneal biopsy specimens from 42 pre-dialysis uraemic patients and 11 control individuals were investigated. Immunohistochemistry for CD68-positive macrophages, chymase- and tryptase-positive mast cells, interleukin-6 (IL-6)-positive cells, CD3-positive T cells, CD20-positive B cells, neutrophils and CD31- and pathologische anatomie Leiden-endothelium (PAL-E)-positive blood vessels in the peritoneum was performed. Baseline dialysate-to-plasma ratio for creatinine (D/P Cr) was determined within 6 months of PD induction. Clinical and laboratory parameters were measured at the time of peritoneal biopsy. Factors associated with peritoneal permeability were assessed by multiple linear regression analysis.
Pre-dialysis uraemic peritoneum showed infiltration by CD68-positive macrophages, and mast cells, as compared with controls. Baseline D/P Cr was correlated with density of CD68-positive macrophages (P < 0.001), IL-6-positive cells (P < 0.001), CD31-positive (P < 0.05) and PAL-E-positive blood vessels (P < 0.05) and serum albumin (P < 0.05). However, baseline peritoneal permeability was not correlated with infiltration by mast cells, B cells, T cells, neutrophils, serum C-reactive protein or other clinical factors. On multiple linear regression analysis, the number of CD68-positive macrophages in peritoneum was an independent predictor for baseline peritoneal permeability (P = 0.009).
Peritoneal macrophage infiltration is predominant in uraemic patients and is an important factor in predicting baseline peritoneal permeability.
据报道，高基础腹膜溶质转运率与持续性腹膜透析（PD）患者的患者和技术生存率降低有关。然而，基础腹膜溶质转运率的决定因素仍不确定。本研究旨在探讨腹膜局部炎症、血管生成和全身炎症与基础腹膜通透性之间的关系。
对 42 例透析前尿毒症患者和 11 例对照者的腹膜活检标本进行了研究。进行了腹膜中 CD68 阳性巨噬细胞、糜酶和胰蛋白酶阳性肥大细胞、白细胞介素-6（IL-6）阳性细胞、CD3 阳性 T 细胞、CD20 阳性 B 细胞、中性粒细胞以及 CD31 和 pathologische anatomie Leiden-endothelium（PAL-E）阳性血管的免疫组织化学染色。在 PD 诱导后 6 个月内测定基础透析液与血浆肌酐比（D/P Cr）。在腹膜活检时测量临床和实验室参数。通过多元线性回归分析评估与腹膜通透性相关的因素。
与对照组相比，透析前尿毒症患者的腹膜有 CD68 阳性巨噬细胞和肥大细胞浸润。基础 D/P Cr 与 CD68 阳性巨噬细胞密度（P < 0.001）、IL-6 阳性细胞密度（P < 0.001）、CD31 阳性（P < 0.05）和 PAL-E 阳性血管密度（P < 0.05）和血清白蛋白（P < 0.05）相关。然而，基础腹膜通透性与肥大细胞、B 细胞、T 细胞、中性粒细胞、血清 C 反应蛋白或其他临床因素无关。多元线性回归分析显示，腹膜中 CD68 阳性巨噬细胞的数量是基础腹膜通透性的独立预测因子（P = 0.009）。
尿毒症患者腹膜中巨噬细胞浸润为主，是预测基础腹膜通透性的重要因素。
