Premium
Inflammatory factors for hypoalbuminemia in J apanese peritoneal dialysis patients
Author(s) -
Shioya Masuyo,
Yoshida Takuya,
Kasai Kenji,
Furuya Ryuichi,
Kato Akihiko,
Mori Noriko,
Matsumoto Yoshihiro,
Kumagai Hiromichi
Publication year - 2013
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12106
Subject(s) - icodextrin , medicine , peritoneal dialysis , hypoalbuminemia , peritoneal equilibration test , albumin , c reactive protein , serum albumin , creatinine , inflammation , systemic inflammation , endocrinology , gastroenterology , continuous ambulatory peritoneal dialysis
Aim Hypoalbuminaemia is a common complication of peritoneal dialysis ( PD ), and the leakage of albumin through peritoneal membrane may be a principal reason for hypoalbuminaemia. However, the relationship between peritoneal inflammation, peritoneal transport properties and hypoalbuminaemia has not been fully elucidated. Methods A cross‐sectional study was performed on 76 Japanese PD patients who had been using a low‐glucose PD solution and icodextrin. Systemic inflammatory markers of C‐reactive protein ( CRP) and serum interleukin‐6 ( IL ‐6), peritoneal effluent markers of dialysate IL ‐6 and CA 125, the dialysate‐to‐plasma ratio of creatinine ( D/Pcr ) and the dialysate protein concentration were measured and examined for their relationship with hypoalbuminaemia. Results There was a significant positive correlation between serum IL ‐6 and dialysate IL ‐6, mean dialysate IL ‐6 being significantly higher than mean serum IL ‐6, suggesting that intraperitoneal inflammation was a principal origin of systemic inflammation. Both serum and dialysate IL ‐6 were significantly correlated with serum albumin (r = −0.25, P < 0.05 and r = −0.32, P < 0.01, respectively). Dialysate IL ‐6 was significantly correlated with D/Pcr and the dialysate protein concentration, and there was a significantly positive association between D/Pcr and the dialysate protein concentration. Dialysate CA 125, which is argued to be a marker of mesothelial cell mass in this study, was positively correlated with D/Pcr and the dialysate protein concentration. The dialysate protein, dialysate IL ‐6 and dialysate CA 125 all increased according to the peritoneal transport rate defined by D/Pcr . A multiple‐regression analysis showed that serum albumin was independently associated with the age, D/Pcr and serum IL ‐6. Conclusion Hypoalbuminaemia was attributable to both the increased peritoneal permeability and systemic inflammation, and intraperitoneal inflammation might contribute to developing these complications.