Shigemoto Emi, Mizuno Masashi, Suzuki Yasuhiro, Kobayashi Kazuma, Sakata Fumiko, Kariya Tetsuyoshi, Katsuno Takayuki, Maruyama Shoichi, Ito Yasuhiko
Nephrology, Nagoya University Postgraduate School of Medicine, Nagoya, Japan.
Nephrology, Nagoya University Postgraduate School of Medicine, Nagoya, Japan
Perit Dial Int. 2019 Jan-Feb;39(1):90-92. doi: 10.3747/pdi.2017.00205.
As a rare complication in patients on peritoneal dialysis (PD), increase of eosinophil (peritoneal dialysate fluid [PDF] eosinophilia), including eosinophilic peritonitis, was observed in PDF. The majority of eosinophilic peritonitis cases are detected during the early phase of PD induction. However, the frequency of and mechanisms underlying PDF eosinophilia remain unclear. We therefore investigated the frequency of PDF eosinophilia and what mechanisms, specifically complement activation, might contribute to its occurrence. In 48 patients, eosinophil counts and concentrations of complement activation products, such as C3a, C5a, and sC5b-9, interleukin (IL)-5, and IL-6 in PDF were evaluated on days 1, 2, and 4 after starting PD therapy. We focused on the relationships between patient background characteristics and eosinophil counts and levels of C3a, C5a, and sC5b-9 as complement activation products in PDF. In 33.3% of PD patients, increased PDF eosinophils were observed on day 1. Eosinophil counts correlated with PDF levels of C3a on days 1 and 2, IL-5 on days 1, 2, and 4, and IL-6 on day 1. In terms of background characteristics, only the duration the PD catheter was left in place differed significantly between PDF eosinophilia and non-PDF eosinophilia. Notably, PDF levels of C3a differed significantly between patients with and without eosinophilia, suggesting that C3a might be a candidate for induction of increased eosinophil.PDF eosinophilia was frequently observed during PD initiation. Our results suggest that PD catheter insertion and complement activation might be related to increases in eosinophils in PDF during PD initiation.
作为腹膜透析（PD）患者的一种罕见并发症，在腹膜透析液（PDF）中观察到嗜酸性粒细胞增多（腹膜透析液嗜酸性粒细胞增多），包括嗜酸性粒细胞性腹膜炎。大多数嗜酸性粒细胞性腹膜炎病例在PD诱导的早期阶段被检测到。然而，PDF嗜酸性粒细胞增多的频率及其潜在机制仍不清楚。因此，我们研究了PDF嗜酸性粒细胞增多的频率以及哪些机制，特别是补体激活，可能导致其发生。在48例患者中，在开始PD治疗后的第1、2和4天评估了PDF中的嗜酸性粒细胞计数以及补体激活产物（如C3a、C5a和sC5b-9）、白细胞介素（IL）-5和IL-6的浓度。我们重点关注患者背景特征与嗜酸性粒细胞计数以及PDF中作为补体激活产物的C3a、C5a和sC5b-9水平之间的关系。在33.3%的PD患者中，在第1天观察到PDF嗜酸性粒细胞增多。嗜酸性粒细胞计数与第1天和第2天的PDF中C3a水平、第1、2和4天的IL-5水平以及第1天的IL-6水平相关。就背景特征而言，只有PD导管留置时间在PDF嗜酸性粒细胞增多和非PDF嗜酸性粒细胞增多之间存在显著差异。值得注意的是，有嗜酸性粒细胞增多和无嗜酸性粒细胞增多的患者之间，PDF中C3a水平存在显著差异，这表明C3a可能是诱导嗜酸性粒细胞增多的一个因素。在PD开始期间经常观察到PDF嗜酸性粒细胞增多。我们的结果表明，PD导管插入和补体激活可能与PD开始期间PDF中嗜酸性粒细胞增多有关。
