Background/aims: The capillary wall coated by the endothelial glycocalyx is the main transport barrier during peritoneal dialysis (PD). Here, we investigated the relationships between measurements of the systemic endothelial glycocalyx and peritoneal transport in PD patients.
Methods: We performed sidestream darkfield (SDF) imaging of the sublingual microvasculature in 15 patients, measured the perfused boundary region (PBR), which includes the permeable part of the glycocalyx, and calculated the estimated blood vessel density (EBVD). All patients underwent a peritoneal permeability analysis.
Results: No relationships were present between the imaging and peritoneal transport parameters, neither in the group as a whole nor in fast transporters. In patients with nonfast peritoneal transport status, PBR had a negative relationship with EBVD and small solute transport, and a positive one with net ultrafiltration (NUF). The EBVD showed a positive correlation with glucose absorption and a negative one with NUF. We found no relationships with the peritoneal transport of albumin.
Conclusions: No relationships are present between the systemic endothelial glycocalyx, which was assessed by SDF, and peritoneal transport. In nonfast transporters, a reduction in blood vessel density caused by endothelial glycocalyx alterations or a thicker permeable phase of the glycocalyx delaying the access of small solutes to the small pores may be important. .
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http://dx.doi.org/10.1159/000368081 | DOI Listing |
Am J Kidney Dis
December 2024
Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington; VA Puget Sound Healthcare System, Seattle, Washington.
Historically, the paradigm for all maladies was associated with an imbalance of the 4 humors: blood, black bile, yellow bile, and phlegm. Although our understanding of disease has evolved significantly since the time of Hippocrates, a similar cornerstone of inpatient and ambulatory care involves understanding and correcting imbalances of volume. The kidneys are the principal organs controlling extracellular volume, capable of both sensing and altering salt retention through multiple redundant pathways, including the sympathetic nervous system and the renin-angiotensin-aldosterone system.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
December 2024
Department of Physiology, Immunology and Pathophysiology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia.
Maintaining the physiological function of the vascular endothelium and endothelial glycocalyx is crucial for the prevention of cardiovascular disease, which is one of the leading causes of morbidity and mortality worldwide. Damage to these structures can lead to atherosclerosis, hypertension, and other cardiovascular problems, especially in individuals with risk factors such as diabetes and obesity. Endothelial dysfunction is associated with ischemic disease and has a negative impact on overall cardiovascular health.
View Article and Find Full Text PDFAdv Sci (Weinh)
December 2024
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
Circulating lactate is a critical biomarker for sepsis-induced acute lung injury (S-ALI) and is strongly associated with poor prognosis. However, whether elevated lactate directly promotes S-ALI and the specific mechanism involved remain unclear. Here, this work shows that lactate causes pulmonary endothelial glycocalyx degradation and worsens ALI during sepsis.
View Article and Find Full Text PDFJ Clin Med
November 2024
Rothschild Foundation Hospital, 75019 Paris, France.
J Clin Med
November 2024
Department of Anesthesiology and Intensive Therapy, Semmelweis University, 78 Üllői St., 1082 Budapest, Hungary.
A dysregulated immune response is associated with an excessive release of cytokines that can lead to systemic vasoplegia and vasoplegic shock with the development of multiorgan failure that is associated with an increased risk of dying. Under physiological circumstances, the endothelium and the glycocalyx are responsible for maintaining vascular tone, capillary permeability, and hemostasis, and controlling inflammation. In hyperinflammation, the endothelium and glycocalyx become damaged due to the excessive production of certain toxic proteins, along with an overwhelming release of cytokines.
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