Nephrol Dial Transplant (2002) 17: 548-551
© 2002 European Renal Association-European Dialysis and Transplant Association
Editorial Comment
New insights in the molecular mechanisms regulating peritoneal permeability
Division of Nephrology, Université Catholique de Louvain Medical School, Brussels, Belgium
Keywords: advanced glycation; aquaporin-1; bFGF; nitric oxide synthase; peritoneal membrane; ultrafiltration; VEGF
Introduction
Peritoneal dialysis (PD) is used in approximately 15% of dialysis patients worldwide. With the reduction of acute peritonitis, the major problem associated with PD is now the high incidence of ultrafiltration (UF) failure, which can affect up to 50% of PD patients treated for more than 6 years [1]. Cross-sectional and longitudinal studies have shown that peritoneal permeability for small solutes increases with time on PD, which induces a faster absorption of glucose, an early dissipation of the osmotic gradient and, eventually, UF failure [1,2]. The relevance of these modifications is illustrated by the fact that high peritoneal membrane (PM) permeability is a significant risk factor, predicting both technical failure and death in PD patients [3]. In this commentary, we will discuss how recent structural, functional and molecular data provide new insights in our understanding of the modifications of the PM in
Structural modifications of the peritoneum
Nitric oxide and the peritoneum
Vascular endothelial growth factor and the peritoneum
Reactive carbonyl compounds and advanced glycation end products in the peritoneum
Does chronic uraemia per se contribute to peritoneal changes?
Conclusion: molecular mechanisms for PM dysfunction in long-term PD
Acknowledgments
Notes
References
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