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Nephrol Dial Transplant (2001) 16: 2299-2302
© 2001 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Glucotoxicity of the peritoneal membrane: the case for VEGF

An S. De Vriese, Siska Mortier and Norbert H. Lameire

Renal Unit, University Hospital, Gent, Belgium

Keywords: vascular endothelial growth factor; glucose degradation products; advanced glycation end-products

Introduction

Although nephrologists are well aware of the devastating consequences of chronic hyperglycaemia in patients with diabetes, the continuous exposure of the peritoneum to the high glucose concentrations present in peritoneal dialysate has been approached with aloof concern. This is rather surprising, as dialysate glucose concentrations are 15 to 40 times the physiological levels and peritoneal dialysis (PD) patients may be exposed to the equivalent of 100 kg of glucose per year.

Long-term PD is associated with the progressive development of functional and structural alterations of the peritoneal membrane. Longitudinal reports suggest that ultrafiltration tends to decrease with time on dialysis [1–2]. In the majority of cases, loss of ultrafiltration capacity can be attributed to a rise in small solute transport, resulting in a rapid dissipation of the transperitoneal osmotic gradient. The presence of high small solute transport rates points to an expansion of the effective peritoneal . . . [Full Text of this Article]

Glucose

Glucose degradation products

Advanced glycation end-products

Strategies to reduce peritoneal exposure to glucose and GDP

Conclusion

Notes

References


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