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Neutral pH and low-glucose degradation product dialysis fluids induce major early alterations of the peritoneal membrane in children on peritoneal dialysis
B. Schaefer, M. Bartosova, S. Macher-Goeppinger, P. Sallay, P. Vörös, B. Ranchin, K. Vondrak, G. Ariceta, A. Zaloszyc, AK. Bayazit, U. Querfeld, R. Cerkauskiene, S. Testa, C. Taylan, J. VandeWalle, Y. Yap, RT. Krmar, R. Büscher, AK. Mühlig, D....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, pozorovací studie, práce podpořená grantem
NLK
Freely Accessible Science Journals
od 1972
Open Access Digital Library
od 1972-01-01
- MeSH
- biopsie MeSH
- chronické selhání ledvin terapie MeSH
- dialyzační roztoky chemie toxicita MeSH
- dítě MeSH
- epitelo-mezenchymální tranzice účinky léků MeSH
- fibróza MeSH
- glukosa metabolismus MeSH
- kojenec MeSH
- koncentrace vodíkových iontů MeSH
- lidé MeSH
- mladiství MeSH
- peritoneální dialýza škodlivé účinky MeSH
- peritoneum krevní zásobení účinky léků patologie MeSH
- peritonitida chemicky indukované patologie MeSH
- předškolní dítě MeSH
- studie případů a kontrol MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
The effect of peritoneal dialysates with low-glucose degradation products on peritoneal membrane morphology is largely unknown, with functional relevancy predominantly derived from experimental studies. To investigate this, we performed automated quantitative histomorphometry and molecular analyses on 256 standardized peritoneal and 172 omental specimens from 56 children with normal renal function, 90 children with end-stage kidney disease at time of catheter insertion, and 82 children undergoing peritoneal dialysis using dialysates with low-glucose degradation products. Follow-up biopsies were obtained from 24 children after a median peritoneal dialysis of 13 months. Prior to dialysis, mild parietal peritoneal inflammation, epithelial-mesenchymal transition and vasculopathy were present. After up to six and 12 months of peritoneal dialysis, blood microvessel density was 110 and 93% higher, endothelial surface area per peritoneal volume 137 and 95% greater, and submesothelial thickness 23 and 58% greater, respectively. Subsequent peritoneal changes were less pronounced. Mesothelial cell coverage was lower and vasculopathy advanced, whereas lymphatic vessel density was unchanged. Morphological changes were accompanied by early fibroblast activation, leukocyte and macrophage infiltration, diffuse podoplanin presence, epithelial mesenchymal transdifferentiation, and by increased proangiogenic and profibrotic cytokine abundance. These transformative changes were confirmed by intraindividual comparisons. Peritoneal microvascular density correlated with peritoneal small-molecular transport function by uni- and multivariate analysis. Thus, in children on peritoneal dialysis neutral pH dialysates containing low-glucose degradation products induce early peritoneal inflammation, fibroblast activation, epithelial-mesenchymal transition and marked angiogenesis, which determines the PD membrane transport function.
1st Department of Pediatrics Semmelweis University Budapest Hungary
Children's Mercy Hospital Kansas City Missouri USA
Department of General Pathology Institute of Pathology University of Heidelberg Heidelberg Germany
Department of Pathology University Medical Center Mainz Mainz Germany
Department of Pediatric Nephrology Faculty of Medicine Cukurova University Adana Turkey
Department of Pediatric Nephrology Istanbul University Cerrahpasa Medical Faculty Istanbul Turkey
Department of Pediatrics 1 University Hospital of Strasbourg Strasbourg France
Department of Pediatrics and Adolescent Medicine Medical University Vienna Austria
Department of Pediatrics Division of Nephrology University of Charité Berlin Germany
Department of Pediatrics Hospital Kuala Lumpur Malaysia
Department of Pediatrics University Hospital Motol Prague Czech Republic
KfH Pediatric Kidney Center Department of Pediatric Nephrology University of Marburg Marburg Germany
Pediatric Nephrology Children's and Adolescent's Hospital University Hospital of Cologne Germany
Pediatric Nephrology University Children's Hospital Essen Germany
Pediatric Nephrology Utopaed Department of Pediatrics Ghent University Hospital Belgium
Service de Néphrologie Pédiatrique Hôpital Femme Mere Enfant Hospices Civils de Lyon Lyon France
Citace poskytuje Crossref.org
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- $a Neutral pH and low-glucose degradation product dialysis fluids induce major early alterations of the peritoneal membrane in children on peritoneal dialysis / $c B. Schaefer, M. Bartosova, S. Macher-Goeppinger, P. Sallay, P. Vörös, B. Ranchin, K. Vondrak, G. Ariceta, A. Zaloszyc, AK. Bayazit, U. Querfeld, R. Cerkauskiene, S. Testa, C. Taylan, J. VandeWalle, Y. Yap, RT. Krmar, R. Büscher, AK. Mühlig, D. Drozdz, S. Caliskan, F. Lasitschka, S. Fathallah-Shaykh, E. Verrina, G. Klaus, K. Arbeiter, R. Bhayadia, A. Melk, P. Romero, BA. Warady, F. Schaefer, A. Ujszaszi, CP. Schmitt,
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- $a The effect of peritoneal dialysates with low-glucose degradation products on peritoneal membrane morphology is largely unknown, with functional relevancy predominantly derived from experimental studies. To investigate this, we performed automated quantitative histomorphometry and molecular analyses on 256 standardized peritoneal and 172 omental specimens from 56 children with normal renal function, 90 children with end-stage kidney disease at time of catheter insertion, and 82 children undergoing peritoneal dialysis using dialysates with low-glucose degradation products. Follow-up biopsies were obtained from 24 children after a median peritoneal dialysis of 13 months. Prior to dialysis, mild parietal peritoneal inflammation, epithelial-mesenchymal transition and vasculopathy were present. After up to six and 12 months of peritoneal dialysis, blood microvessel density was 110 and 93% higher, endothelial surface area per peritoneal volume 137 and 95% greater, and submesothelial thickness 23 and 58% greater, respectively. Subsequent peritoneal changes were less pronounced. Mesothelial cell coverage was lower and vasculopathy advanced, whereas lymphatic vessel density was unchanged. Morphological changes were accompanied by early fibroblast activation, leukocyte and macrophage infiltration, diffuse podoplanin presence, epithelial mesenchymal transdifferentiation, and by increased proangiogenic and profibrotic cytokine abundance. These transformative changes were confirmed by intraindividual comparisons. Peritoneal microvascular density correlated with peritoneal small-molecular transport function by uni- and multivariate analysis. Thus, in children on peritoneal dialysis neutral pH dialysates containing low-glucose degradation products induce early peritoneal inflammation, fibroblast activation, epithelial-mesenchymal transition and marked angiogenesis, which determines the PD membrane transport function.
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