Cai Michael M X, Smith Edward R, Kent Annette, Huang Louis, Hewitson Timothy D, McMahon Lawrence P, Holt Stephen G
Department of Nephrology, The Royal Melbourne Hospital, Melbourne, Australia
Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne, Australia.
Perit Dial Int. 2018 Jul-Aug;38(4):286-292. doi: 10.3747/pdi.2017.00163. Epub 2018 May 23.
The accumulation of fetuin-A-containing calciprotein particles (CPP) in the serum of patients with renal disease and those with chronic inflammation may be involved in driving sterile inflammation and extraosseous mineral deposition. We previously showed that both fetuin-A and CPP were present in the peritoneal dialysis (PD) effluent of stable PD patients. It is unknown whether different PD fluids might affect the formation of CPP .
Peritoneal effluent from 12 patients was collected after a 6-hour dwell with 7 different commercial PD fluids. Calciprotein particles and inflammatory cytokines were measured by flow cytometry.
High inter-subject variability in CPP concentration was observed. Peritoneal dialysis fluids containing 1.75 mmol/L calcium were associated with enhanced formation of CPP , compared with fluids containing 1.25 mmol/L calcium. Osmotic agent, fluid pH, and glucose concentration did not affect CPP formation. Peritoneal dialysis effluent CPP levels were not associated with changes in inflammatory cytokines.
High calcium-containing PD fluids favor intraperitoneal CPP formation. This finding may have relevance for future PD fluid design.
肾病患者和慢性炎症患者血清中含胎球蛋白-A的钙蛋白颗粒（CPP）的积累可能参与引发无菌性炎症和骨外矿物质沉积。我们之前表明，稳定腹膜透析（PD）患者的腹膜透析流出液中同时存在胎球蛋白-A和CPP。不同的腹膜透析液是否会影响CPP的形成尚不清楚。
使用7种不同的市售腹膜透析液进行6小时留腹后，收集12例患者的腹膜流出液。通过流式细胞术测量钙蛋白颗粒和炎性细胞因子。
观察到CPP浓度存在较高的个体间变异性。与含钙1.25 mmol/L的透析液相比，含钙1.75 mmol/L的腹膜透析液与CPP形成增加有关。渗透剂、透析液pH值和葡萄糖浓度不影响CPP的形成。腹膜透析流出液CPP水平与炎性细胞因子的变化无关。
高钙腹膜透析液有利于腹腔内CPP的形成。这一发现可能与未来腹膜透析液的设计有关。
