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首页> 外文期刊>Peritoneal dialysis international: Journal of the International Society for Peritoneal Dialysis >Peritoneal accumulation of AGE and peritoneal membrane permeability.
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Peritoneal accumulation of AGE and peritoneal membrane permeability.

机译：AGE的腹膜积聚和腹膜的通透性。

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摘要

BACKGROUND: In continuous ambulatory peritoneal dialysis (CAPD), the peritoneal membrane is continuously exposed to high-glucose-containing dialysis solutions. Abnormally high glucose concentration in the peritoneal cavity may enhance advanced glycosylation end-product (AGE) formation and accumulation in the peritoneum. Increased AGE accumulation in the peritoneum, decreased ultrafiltration volume, and increased peritoneal permeability in long-term dialysis patients have been reported. AIM: The purpose of the study was to evaluate the relation between peritoneal membrane permeability and peritoneal accumulation of AGE. METHODS: Peritoneal membrane permeability was evaluated by peritoneal equilibration test (PET) using dialysis solutions containing 4.25% glucose. Serum, dialysate, and peritoneal tissue levels of AGE were measured by ELISA method using polyclonal anti-AGE antibody. Peritoneal biopsy was performed during peritoneal catheter insertion [new group (group N), n = 18] and removal [long-term group (group LT), n = 10]. Peritoneal catheters were removed due to exit-site infection not extended into the internal cuff (n = 6) and ultrafiltration failure (n = 4) after 51.6+/-31.5 months (13 - 101 months) of dialysis. PET data obtained within 3 months after the initiation of CAPD or before catheter removal were included in this study. Ten patients in group N and 4 patients in group LT were diabetic. Patients in group LT were significantly younger (46.5+/-11.1 years vs 57.5+/-1.3 years) and experienced more episodes of peritonitis (3.5+/-2.1 vs 0.2+/-0.7) than group N. RESULTS: Peritoneal tissue AGE level in group LT was significantly higher than in group N, in both nondiabetic (0.187+/-0.108 U/mg vs 0.093+/-0.08 U/mg of hydroxyproline, p < 0.03) and diabetic patients (0.384+/-0.035 U/mg vs 0.152+/-0.082 U/mg of hydroxyproline, p < 0.03), while serum and dialysate levels did not differ between the groups in both nondiabetic and diabetic patients. Drain volume (2600+/-237 mL vs 2766+/-222 mL, p = 0.07) and D4/D0 glucose (0.229+/-0.066 vs 0.298+/-0.081, p < 0.009) were lower, and D4/P4 creatinine (0.807+/-0.100 vs 0.653+/-0.144, p< 0.0001) and D1/P1 sodium (0.886+/-0.040 vs 0.822+/-0.032, p < 0.0003) were significantly higher in group LT than in group N. On linear regression analysis, AGE level in the peritoneum was directly correlated with duration of CAPD (r = 0.476, p = 0.012), number of peritonitis episodes (r = 0.433, p = 0.0215), D4/P4 creatinine (r = 0.546, p < 0.027), and D1/P1 sodium (r = 0.422, p = 0.0254), and inversely correlated with drain volume (r = 0.432, p = 0.022) and D4/D0 glucose (r = 0.552, p < 0.0023). AGE level in the peritoneal tissue and dialysate were significantly higher in diabetics than in nondiabetics in group LT, while these differences were not found in group N. Serum AGE level did not differ between nondiabetics and diabetics in either group N or group LT. Drain volume and D4/D0 glucose were lower and D4/P4 creatinine and D1/P1 sodium higher in diabetics than in nondiabetics in both groups. CONCLUSION: Peritoneal accumulation of AGE increased with time on CAPD and number of peritonitis episodes, and was directly related with peritoneal permeability. Peritoneal AGE accumulation and peritoneal permeability in diabetic patients were higher than in nondiabetic patients from the beginning of CAPD.
机译：背景：在连续非卧床腹膜透析（CAPD）中，腹膜连续暴露于高葡萄糖的透析溶液中。腹腔中异常高的葡萄糖浓度可能会增强晚期糖基化终产物（AGE）的形成和在腹膜中的积累。据报道，长期透析患者腹膜中AGE积累增加，超滤量减少和腹膜通透性增加。目的：本研究的目的是评估腹膜渗透性与AGE的腹膜蓄积之间的关系。方法：采用含4.25％葡萄糖的透析液，通过腹膜平衡试验（PET）评估腹膜的通透性。使用多克隆抗AGE抗体，通过ELISA法测定血清，透析液和腹膜组织水平。在腹膜导管插入[新组（N组），n = 18]和切除[长期组（LT组），n = 10]期间进行腹膜活检。在透析51.6 +/- 31.5个月（13-101个月）后，由于出口部位感染未延伸至内部袖带（n = 6）和超滤失败（n = 4）而移除了腹膜导管。该研究包括在CAPD开始后3个月内或拔除导管前3个月内获得的PET数据。 N组10例，LT组4例为糖尿病。 LT组的患者明显比N组年轻（46.5 +/- 11.1岁对57.5 +/- 1.3岁），并经历了更多的腹膜炎发作（3.5 +/- 2.1对0.2 +/- 0.7）。结果：腹膜组织AGE在非糖尿病患者（0.187 +/- 0.108 U / mg vs. 0.093 +/- 0.08 U / mg羟脯氨酸，p <0.03）和糖尿病患者（0.384 +/- 0.035 U）中，LT组的血清水平均显着高于N组。 / mg对比羟脯氨酸的0.152 +/- 0.082 U / mg，p <0.03），而非糖尿病和糖尿病患者的血清和透析液水平在两组之间没有差异。排液量（2600 +/- 237 mL对2766 +/- 222 mL，p = 0.07）和D4 / D0葡萄糖（0.229 +/- 0.066对0.298 +/- 0.081，p <0.009）较低，D4 / P4 LT组的肌酐（0.807 +/- 0.100 vs 0.653 +/- 0.144，p <0.0001）和D1 / P1钠盐（0.886 +/- 0.040 vs 0.822 +/- 0.032，p <0.0003）显着高于N组。在线性回归分析中，腹膜中的AGE水平与CAPD持续时间（r = 0.476，p = 0.012），腹膜炎发作次数（r = 0.433，p = 0.0215），D4 / P4肌酐（r = 0.546）直接相关。 ，p <0.027）和D1 / P1钠（r = 0.422，p = 0.0254），并且与排液量（r = 0.432，p = 0.022）和D4 / D0葡萄糖成反比（r = 0.552，p <0.0023） 。 LT组的糖尿病患者腹膜组织和透析液中的AGE水平显着高于非糖尿病患者，而在N组中没有发现这些差异。N组或LT组中非糖尿病患者和糖尿病患者的血清AGE水平没有差异。两组糖尿病患者的排泄量和D4 / D0葡萄糖均较低，而D4 / P4肌酐和D1 / P1钠较高。结论：随着时间的推移，CAPD和腹膜炎发作次数增加了腹膜AGE的积累，并与腹膜通透性直接相关。从CAPD开始，糖尿病患者的腹膜AGE积累和腹膜通透性高于非糖尿病患者。

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