Li Jianzhong, Lan Jingjing, Qiao Qing, Shen Lei, Lu Guoyuan
Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, People's Republic of China.
Open Med (Wars). 2021 Jun 7;16(1):847-853. doi: 10.1515/med-2021-0302. eCollection 2021.
Long-term peritoneal dialysis (PD) is accompanied by low-grade intraperitoneal inflammation and may eventually lead to peritoneal membrane injury with a high solute transport rate and ultrafiltration failure. Osteopontin (OPN) is highly expressed through the stimulation of pro-inflammatory cytokines in many cell types. This study aimed to investigate the potential of OPN as a new indicator of peritoneal deterioration. One hundred nine continuous ambulatory PD patients were analyzed. The levels of OPN and IL-6 in peritoneal effluents or serum were analyzed by ELISA kits. The mean effluent OPN concentration was 2.39 ± 1.87 ng/mL. The OPN levels in drained dialysate were correlated with D/P Cr ( < 0.0001, = 0.54) and D/D0 glucose ( < 0.0001, = 0.39). Logistic regression analysis showed that the OPN levels in peritoneal effluents were an independent predictive factor for the increased peritoneal solute transport rate (PSTR) obtained by the peritoneal equilibration test ( < 0.001). The area under the receiver operating characteristic curve of OPN was 0.84 (95% CI: 0.75-0.92) in predicting the increased PSTR with a sensitivity of 86% and a specificity of 67%. The joint utilization of effluent OPN with age, effluent IL-6, and serum albumin further increased the specificity (81%). Thus, OPN may be a useful indicator of peritoneal deterioration in patients with PD.
长期腹膜透析(PD)伴有低度腹腔内炎症,最终可能导致腹膜损伤,出现高溶质转运率和超滤失败。骨桥蛋白(OPN)在多种细胞类型中通过促炎细胞因子的刺激而高表达。本研究旨在探讨OPN作为腹膜恶化新指标的潜力。分析了109例持续性非卧床腹膜透析患者。采用酶联免疫吸附测定试剂盒分析腹膜透析液或血清中OPN和IL-6的水平。腹膜透析液中OPN的平均浓度为2.39±1.87 ng/mL。引流透析液中的OPN水平与D/P Cr(<0.0001,r=0.54)和D/D0葡萄糖(<0.0001,r=0.39)相关。逻辑回归分析表明,腹膜透析液中的OPN水平是腹膜平衡试验获得的腹膜溶质转运率(PSTR)增加的独立预测因素(<0.001)。OPN在预测PSTR增加时的受试者工作特征曲线下面积为0.84(95%CI:0.75-0.92),敏感性为86%,特异性为67%。将透析液OPN与年龄、透析液IL-6和血清白蛋白联合使用可进一步提高特异性(81%)。因此,OPN可能是腹膜透析患者腹膜恶化的一个有用指标。