1. Prognostic significance of peritoneal dialysis effluent mitochondrial DNA level
- Author
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Phyllis Mei-Shan Cheng, Jack Kit-Chung Ng, Ka-Bik Lai, Gordon Chun-Kau Chan, Win Hlaing Than, Cathy Choi-Wan Luk, Kai-Ming Chow, Winston Wing-Shing Fung, and Cheuk-Chun Szeto
- Subjects
0301 basic medicine ,Mitochondrial DNA ,medicine.medical_treatment ,Clinical Biochemistry ,Systemic inflammation ,DNA, Mitochondrial ,Biochemistry ,Peritoneal dialysis ,Andrology ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Dialysis Solutions ,Overall survival ,Humans ,Medicine ,Effluent ,business.industry ,Biochemistry (medical) ,Protein level ,General Medicine ,Prognosis ,medicine.disease ,030104 developmental biology ,030220 oncology & carcinogenesis ,Peritoneum ,medicine.symptom ,Metabolic syndrome ,business ,Peritoneal Dialysis - Abstract
Mitochondrial DNA (mtDNA) resembles bacterial DNA and potentially triggers local and systemic inflammation. We evaluate the prognostic implications of PD effluent mtDNA level in peritoneal dialysis (PD) patients.We measured mtDNA in the PD effluent (PDE) sediment and supernatant of 168 incident PD patients. All patients were followed for hospitalization, technique and overall survival.The median PD effluent supernatant and sediment mtDNA levels were 255.4 unit (interquartile range [IQR] 157.5-451.3) and 201.6 unit (IQR 147.8-267.3), respectively. Serum C-reactive protein level closely with PDE sediment mtDNA level (r = 0.471, p 0.001) and less with supernatant mtDNA level (r = 0.156, p = 0.044). PDE supernatant mtDNA level correlates with dialysate-to-plasma creatinine ratio at 4 h (D/P4) (r = 0.361, p 0.001) but not with any clinical outcome. PDE sediment mtDNA was an independent predictor of technique survival (p = 0.011) and the duration of hospitalization (p = 0.044) after adjusting for clinical confounding factors.PDE sediment mtDNA level significantly correlated with systemic inflammation, while PDE supernatant mtDNA level correlated with peritoneal transport. PDE sediment mtDNA level also independently predicted technique survival and duration of hospitalization. The mechanism of the different implications between PDE sediment and supernatant mtDNA levels deserves further investigations.
- Published
- 2021