Nephrol Dial Transplant (2002) 17: 1480-1486
© 2002 European Renal Association-European Dialysis and Transplant Association
Plasma and dialysate IL-6 and VEGF concentrations are associated with high peritoneal solute transport rate
1 Nephrology Division, University of São Paulo School of Medicine, São Paulo, Brazil and 2 Divisions of Baxter Novum and Renal Medicine, Karolinska Institutet, Stockholm, Sweden
Background. It has been speculated that increased levels of circulating or intraperitoneal pro-inflammatory cytokines such as interleukin 6, and pro-angiogenic vascular endothelial growth factor (VEGF) may contribute to high peritoneal small-solute transport rate (PSTR) in continuous ambulatory peritoneal dialysis (CAPD) patients. In this study we evaluated possible relationships between plasma and dialysate IL-6 and VEGF levels and PSTR.
Methods. Forty CAPD patients (mean age±SD of 58±14 years) with no apparent inflammation process or disease, who had been on CAPD for 19±15 months (range 3–56 months) were included in the study. Peritoneal equilibration test (PET) was used to evaluate PSTR. Patients were divided into two groups: high-average and high transporters (H/A; D/Pcreat
0.65) and low-average and low transporters (L/A; D/Pcreat<0.64). Albumin and IgG clearances were used in the evaluation of permeability to larger solutes. Plasma and overnight dialysate levels of IL-6 and VEGF were measured.
Results. Plasma IL-6 (7.6 vs 4.3 pg/ml) and VEGF (342 vs 163 pg/ml) as well as dialysate IL-6 (174 vs 80 pg/ml) and VEGF (96 vs 69 pg/ml) levels were significantly higher in the H/A than in the L/A group. The dialysate appearance of IL-6 and VEGF correlated with D/Pcreat, as well as with albumin and IgG clearances. Moreover, significant correlations were noted between dialysate IL-6 and dialysate VEGF levels.
Conclusions. The findings of (i) increased plasma and dialysate levels of IL-6 and VEGF in the H/A group compared to the L/A group, (ii) an association between PSTR and both plasma and dialysate IL-6 and VEGF levels, and (iii) a significant correlation between dialysate IL-6 and VEGF concentrations suggest that inflammation, angiogenesis, and peritoneal transport may be interrelated and involved in the pathophysiology of high PSTR in CAPD patients. However, due to the cross-sectional design of this study, the cause and effect relationships between plasma and dialysate IL-6 and VEGF concentrations and high PSRT remain unclear.
Keywords: angiogenesis; IL-6; inflammation; peritoneal dialysis; peritoneal transport; VEGF
Correspondence and offprint requests to: Roberto Pecoits-Filho, Renal Physiopathology Laboratory (LIM-16), University of São Paulo School of Medicine, Av. Dr Arnaldo, 455 – Sala 3342, São Paulo – SP, Brazil CEP – 01246–903. Email: pecoits{at}usp.br
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