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首页> 美国卫生研究院文献>other >Sustained low peritoneal effluent CCL18 levels are associated with preservation of peritoneal membrane function in peritoneal dialysis
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Sustained low peritoneal effluent CCL18 levels are associated with preservation of peritoneal membrane function in peritoneal dialysis

机译：腹膜流出液的持续低水平与腹膜透析中腹膜功能的维持有关

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Peritoneal membrane failure (PMF) and, ultimately, encapsulating peritoneal sclerosis (EPS) are the most serious peritoneal dialysis (PD) complications. Combining clinical and peritoneal transport data with the measurement of molecular biomarkers, such as the chemokine CCL18, would improve the complex diagnosis and management of PMF. We measured CCL18 levels in 43 patients’ effluent and serum at baseline and after 1, 2, and 3 years of PD treatment by retrospective longitudinal study, and evaluated their association with PMF/EPS development and peritoneal risk factors. To confirm the trends observed in the longitudinal study, a cross-sectional study was performed on 61 isolated samples from long-term (more than 3 years) patients treated with PD. We observed that the patients with no membrane dysfunction showed sustained low CCL18 levels in peritoneal effluent over time. An increase in CCL18 levels at any time was predictive of PMF development (final CCL18 increase over baseline, p = .014; and maximum CCL18 increase, p = .039). At year 3 of PD, CCL18 values in effluent under 3.15 ng/ml showed an 89.5% negative predictive value, and higher levels were associated with later PMF (odds ratio 4.3; 95% CI 0.90–20.89; p = .067). Moreover, CCL18 levels in effluent at year 3 of PD were independently associated with a risk of PMF development, adjusted for the classical (water and creatinine) peritoneal transport parameters. These trends were confirmed in a cross-sectional study of 61 long-term patients treated with PD. In conclusion, our study shows the diagnostic capacity of chemokine CCL18 levels in peritoneal effluent to predict PMF and suggests CCL18 as a new marker and mediator of this serious condition as well as a new potential therapeutic target.
机译：腹膜衰竭（PMF）以及最终包囊性腹膜硬化（EPS）是最严重的腹膜透析（PD）并发症。将临床和腹膜运输数据与分子生物标记物（例如趋化因子CCL18）的测量结果相结合，将改善PMF的复杂诊断和管理。我们通过回顾性纵向研究测量了基线时以及PD治疗1年，2年和3年后43例患者流出物和血清中CCL18的水平，并评估了它们与PMF / EPS发育和腹膜危险因素的关系。为了证实在纵向研究中观察到的趋势，对来自接受PD治疗的长期（3年以上）患者的61份分离样本进行了横断面研究。我们观察到没有膜功能障碍的患者随着时间的推移在腹膜流出物中显示出持续低的CCL18水平。在任何时候，CCL18水平的增加都是PMF发生的预兆（最终CCL18比基线增加，p = .014；最大CCL18增加，p = .039）。在PD的第3年，流出液中CCL18值低于3.15 ng / ml时显示89.5％的阴性预测值，较高的水平与后期PMF相关（比值比4.3； 95％CI 0.90-20.89； p = .067）。此外，PD的第3年废水中的CCL18水平与PMF发生风险独立相关，并针对经典（水和肌酐）腹膜运输参数进行了调整。在对61名接受PD治疗的长期患者的横断面研究中证实了这些趋势。总之，我们的研究显示了腹膜排出物中趋化因子CCL18水平对PMF的诊断能力，并建议CCL18作为这种严重疾病的新标志物和介质以及新的潜在治疗靶标。

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