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Background: Despite several advantages compared to haemodialysis (HD), peritoneal dialysis (PD) remains an underused dialysis technique due to its high technique failure rate related to membrane fibrosis and peritonitis events. Previous work has suggested a harmful role for the complement system in these processes, highlighting the need for a more comprehensive examination in PD.
Methods: Plasma levels of C1q, mannose-binding lectin (MBL), Properdin, Factor D, C3d/C3-ratio and soluble membrane attack complex (sC5b-9) were determined in PD patients ( = 55), HD patients ( = 41), non-dialysis chronic kidney disease (CKD) patients ( = 15) and healthy controls ( = 14). Additionally, C1q, MBL, Properdin, Factor D and sC5b-9 levels were assessed in the peritoneal dialysis fluid (PDF). In a subgroup, interleukin-6, matrix metalloproteinase-2 (MMP-2), myeloperoxidase (MPO) and elastase were measured in the PDF.
Results: PD patients had significantly higher systemic levels of sC5b-9 compared to healthy controls, CKD and HD patients ( < 0.001). Plasma levels of C1q and C3d/C3-ratios were significantly associated with systemic sC5b-9 levels ( < 0.001). Locally, sC5b-9 was detected in the PDF of all PD patients, and levels were approximately 33% of those in matched plasma, but they did not correlate. In the PDF, only Properdin levels remained significantly associated with PDF sC5b-9 levels in multivariate analysis ( < 0.001). Additionally, PDF levels of sC5b-9 positively correlated with elastase, MPO and MMP-2 levels in the PDF ( < 0.01).
Conclusions: Our data reveal both systemic and local complement activation in PD patients. Furthermore, these two processes seem independent considering the involvement of different pathways and the lack of correlation.
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http://dx.doi.org/10.1177/08968608231198984 | DOI Listing |
Clin Exp Nephrol
December 2024
Apheresis and Dialysis Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku , Tokyo, 1608582, Japan.
Cureus
November 2024
Department of Nephrology, Nagasaki University Hospital, Nagasaki, JPN.
A 46-year-old woman on peritoneal dialysis (PD) had cloudy peritoneal dialysis effluent that had persisted for 10 days by the time she visited our hospital. The white blood cell count in the effluent was elevated to 1500/μL, leading to a diagnosis of peritoneal dialysis-associated peritonitis. The effluent cleared within two days with treatment using cefazolin and ceftazidime, and the white blood cell count dropped to 0/μL by day 6.
View Article and Find Full Text PDFPLOS Glob Public Health
December 2024
Centre for Kidney Disease Research, University of Queensland, Brisbane, Queensland, Australia.
Vulnerable populations, such as the elderly, children, displaced people, and refugees, often encounter challenges in accessing healthcare. In this study, we used data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) to describe kidney care access and delivery to vulnerable populations across countries and regions. Using data from an international survey of clinicians, policymakers, and patient advocates, we assessed the funding and coverage of vulnerable populations on all aspects of kidney replacement therapies (KRT).
View Article and Find Full Text PDFWorld J Psychiatry
December 2024
Department of Nephrology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China.
Background: Anxiety is a common psychological comorbidity in patients undergoing dialysis, yet its impact on treatment adherence and complication rates remains understudied. We designed a longitudinal observational study to investigate these relationships, based on the hypothesis that higher anxiety symptoms would be associated with increased complication rates and negatively associated with adherence to the dialysis regimen.
Aim: To investigate the relationship between anxiety symptoms, dialysis adherence, and complication rates in patients undergoing dialysis over a 24-month period.
Front Digit Health
December 2024
Department of Medical Education, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background: The rapid development of artificial intelligence (AI) has shown great potential in medical document generation. This study aims to evaluate the performance of Claude 3.5-Sonnet, an advanced AI model, in generating discharge summaries for patients with renal insufficiency, compared to human physicians.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!