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Background and Aims Peritoneal dialysis (PD) is a common used method for renal replacement therapy. Prolonged PD treatment causes structural and functional changes in the peritoneal membrane which are attributed to local inflammatory process in the peritoneal cavity. Galectin-3 (Gal-3) is a galactoside-binding lectin with pro-inflammatory and pro-fibrotic effects. The aim of this study was to assess correlation between Gal-3 serum and dialysate effluent levels with peritoneal membrane transport characteristics. Method Gal-3 levels in serum and dialysate effluent were measured simultaneously in prevalent PD patients in morning visit or during peritoneal equilibration test (PET). Gal-3 levels were correlated with clinical and laboratory parameters. Interlukin (IL) -6 levels were measured in dialysate effluent. Gal-3 mRNA and protein expression were evaluated after exposure of primary endothelial cell culture to several dialysate solutions. Results 37 PD patients were included in the study; mean age was 65.7±13.1 years, mean dialysis vintage was 17.5±13 months. Gal-3 levels in dialysate effluent correlated with peritoneal equilibration test (PET) results (0.663, p=0.005) and effluent IL-6 levels (0.674, p=0.002) but not with serum Gal-3 levels or dialysis vintage. Patients with high PET results had higher effluent Gal-3 levels as compared average low PET results. In multivariate regression analysis effluent IL-6 level was the most dominant predictor of effluent Gal-3 levels. Gal-3 mRNA and protein expression in primary endothelial cell culture were not affected by stimulation with dialysate solutions. Conclusion Our study demonstrated presence of Gal-3 within the dialysate effluent in PD patients. Gal-3 levels correlated with peritoneal membrane transport characteristics and effluent IL-6 levels suggesting a role in the inflammatory process within the peritoneal cavity.

Background and Aims Intra-cranial arterial calcification (ICAC) in hemodialysis (HD) patients has a prevalence of about 90%, and its severity is correlated with age, hemodialysis vintage and mineral bone disease. Elevated concentrations of calcium and phosphorus are not sufficient to induce medial calcification because of inhibition by pyrophosphate. Alkaline Phosphatase (ALP) promotes vascular calcification by hydrolyzing pyrophosphate. Epigenetic mechanisms regulation by Apabetalone downregulates pathways involved in vascular calcification. This study assessed the combined impact of ICAC and elevated serum ALP on mortality among chronic HD patients. Method vascular calcifications represented by ICAC were measured simultaneous with mineral bone disease parameters including serum ALP of chronic HD patients who underwent non-contrast brain computerized tomography (CT) from 2015 to 2018 in our institution. Results This retrospective study included 153 hemodialysis patients (mean age 71.3±12.1 years, 60.1% male). Of the total cohort, 12(7.8%) had no brain calcifications and 69 (45.1%) had multiple intracranial calcifications. Considering the patients with normal ALP and no calcification as the reference group yielded adjusted odds ratios for all-cause mortality of 4.6 (95%CI 1.7-12.7) among patients with brain calcifications and normal ALP, p=0.003, and odds ratios for all-cause mortality of 6.1 (95%CI 2.1-17.7) among patients with brain calcifications and increased ALP. Conclusion We founded an independent association between ICAC and the risk of death among hemodialysis patients. The combined effect of ICAC and increased ALP was significantly associated with higher odds-ratio for all-cause mortality in chronic HD patients and may contribute to the risk stratification of these patients.