Than Win Hlaing, Ng Jack Kit-Chung, Fung Winston Wing-Shing, Chan Gordon Chun-Kau, Lai Ka-Bik, Luk Cathy Choi-Wan, Cheng Phyllis Mei-Shan, Chow Kai-Ming, Szeto Cheuk-Chun
Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, Hong Kong, China; Li Ka Shing Institute of Health Sciences (LiHS), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, Hong Kong, China.
Clin Chim Acta. 2021 Aug;519:1-9. doi: 10.1016/j.cca.2021.03.028. Epub 2021 Apr 4.
Mitochondrial DNA (mtDNA) resembles bacterial DNA and potentially triggers local and systemic inflammation. We evaluate the prognostic implications of PD effluent mtDNA level in peritoneal dialysis (PD) patients.
We measured mtDNA in the PD effluent (PDE) sediment and supernatant of 168 incident PD patients. All patients were followed for hospitalization, technique and overall survival.
The median PD effluent supernatant and sediment mtDNA levels were 255.4 unit (interquartile range [IQR] 157.5-451.3) and 201.6 unit (IQR 147.8-267.3), respectively. Serum C-reactive protein level closely with PDE sediment mtDNA level (r = 0.471, p < 0.001) and less with supernatant mtDNA level (r = 0.156, p = 0.044). PDE supernatant mtDNA level correlates with dialysate-to-plasma creatinine ratio at 4 h (D/P4) (r = 0.361, p < 0.001) but not with any clinical outcome. PDE sediment mtDNA was an independent predictor of technique survival (p = 0.011) and the duration of hospitalization (p = 0.044) after adjusting for clinical confounding factors.
PDE sediment mtDNA level significantly correlated with systemic inflammation, while PDE supernatant mtDNA level correlated with peritoneal transport. PDE sediment mtDNA level also independently predicted technique survival and duration of hospitalization. The mechanism of the different implications between PDE sediment and supernatant mtDNA levels deserves further investigations.
线粒体DNA（mtDNA）类似于细菌DNA，可能引发局部和全身炎症。我们评估了腹膜透析（PD）患者腹透液mtDNA水平的预后意义。
我们测量了168例新发PD患者腹透液（PDE）沉淀物和上清液中的mtDNA。所有患者均随访住院情况、技术生存和总生存情况。
PDE上清液和沉淀物mtDNA水平的中位数分别为255.4单位（四分位数间距[IQR]157.5 - 451.3）和201.6单位（IQR 147.8 - 267.3）。血清C反应蛋白水平与PDE沉淀物mtDNA水平密切相关（r = 0.471，p < 0.001），与上清液mtDNA水平相关性较小（r = 0.156，p = 0.044）。PDE上清液mtDNA水平与4小时透析液与血浆肌酐比值（D/P4）相关（r = 0.361，p < 0.001），但与任何临床结局均无关。在调整临床混杂因素后，PDE沉淀物mtDNA是技术生存（p = 0.011）和住院时间（p = 0.044）的独立预测因素。
PDE沉淀物mtDNA水平与全身炎症显著相关，而PDE上清液mtDNA水平与腹膜转运相关。PDE沉淀物mtDNA水平还可独立预测技术生存和住院时间。PDE沉淀物和上清液mtDNA水平不同影响的机制值得进一步研究。
