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Altering peritoneal membrane function: removing the GAG?
1 Institute of Nephrology 2 Department of Infection, Immunity and Biochemistry, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
Correspondence and offprint requests to: Donald J. Fraser; E-mail: fraserdj@cf.ac.uk
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Peritoneal dialysis (PD) is a highly effective and convenient mode of renal replacement therapy. The success of PD depends on maintaining the structural and functional integrity of the peritoneal membrane. The outer (serosal) part of the peritoneal membrane consists of a monolayer of mesothelial cells, which provide a low-friction surface, allowing internal organs to move relative to one another. The membrane acts as a selective permeability barrier, regulating the passage of water and solutes between the intravascular compartment and the peritoneal cavity. Duration of PD is often limited by peritoneal membrane failure, associated with increased solute transport, ultrafiltration dysfunction and with characteristic degenerative changes in the peritoneal membrane, including mesothelial cell loss, accumulation of sub-mesothelial extracellular matrix and vasculopathy (Figure 1) [1].
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