Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy.
Department of Epidemiology, Preclinical Research and Advanced Diagnostics, National Institute for Infectious Diseases L., Spallanzani, IRCCS, Via Portuense, 292, 00149 Rome, Italy.
Int J Mol Sci. 2023 Mar 17;24(6):5763. doi: 10.3390/ijms24065763.
Chronic kidney disease (CKD) incidence is growing worldwide, with a significant percentage of CKD patients reaching end-stage renal disease (ESRD) and requiring kidney replacement therapies (KRT). Peritoneal dialysis (PD) is a convenient KRT presenting benefices as home therapy. In PD patients, the peritoneum is chronically exposed to PD fluids containing supraphysiologic concentrations of glucose or other osmotic agents, leading to the activation of cellular and molecular processes of damage, including inflammation and fibrosis. Importantly, peritonitis episodes enhance peritoneum inflammation status and accelerate peritoneal injury. Here, we review the role of immune cells in the damage of the peritoneal membrane (PM) by repeated exposure to PD fluids during KRT as well as by bacterial or viral infections. We also discuss the anti-inflammatory properties of current clinical treatments of CKD patients in KRT and their potential effect on preserving PM integrity. Finally, given the current importance of coronavirus disease 2019 (COVID-19) disease, we also analyze here the implications of this disease in CKD and KRT.
慢性肾脏病（CKD）的发病率在全球范围内不断上升，相当一部分 CKD 患者进展至终末期肾病（ESRD），需要肾脏替代治疗（KRT）。腹膜透析（PD）是一种方便的 KRT，具有家庭治疗的优势。在 PD 患者中，腹膜长期暴露于含有超生理浓度葡萄糖或其他渗透剂的 PD 液中，导致细胞和分子损伤过程的激活，包括炎症和纤维化。重要的是，腹膜炎发作会加重腹膜炎症状态并加速腹膜损伤。在这里，我们综述了免疫细胞在 KRT 过程中反复暴露于 PD 液以及细菌或病毒感染时对腹膜（PM）损伤的作用。我们还讨论了目前 KRT 中 CKD 患者的临床治疗的抗炎特性及其对维持 PM 完整性的潜在影响。最后，鉴于 2019 年冠状病毒病（COVID-19）的当前重要性，我们还在此分析了该疾病对 CKD 和 KRT 的影响。
