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7. Local and systemic endothelial injury in renal failure treated with peritoneal dialysis

Author

Yu, Zanzhe

Subjects
617.4, R Medicine (General)
Abstract

Excess fluid and waste products of metabolism, as well as protein, are removed from the peritoneal cavity in Peritoneal Dialysis (PD). Increased peritoneal protein clearance (Pcl) is associated with a greater risk of mortality. It is not clear whether this association reflects systemic endothelial injury or local peritoneal capillary damage and inflammation, or both. To investigate this problem a series of analyses were undertaken in different incident, prevalent and longitudinal patient cohorts. Transcapillary escape rate of albumin (TERalb) was measured to determine systemic capillary permeability. Luminex assays combined with principle component analysis were applied to measure endothelial biomarker patterns. It was demonstrated that: (1) Pcl is a function of both local peritoneal inflammation, membrane area (PSTR) and comorbidity (especially cardiovascular) but only its association with the latter predicted survival. (2) There is a progressive uncoupling of the Pcl, (indicative of large pore pathway) and PSTR (effectively the small pore area) with time on PD. (3) Isolated small pore ultrafiltration (due to icodextrin) decreases with prolonged time on PD and is also uncoupled from the increase in peritoneal membrane area. (4) The systemic endothelial barrier function is decreased in PD patients, especially diabetics, but not associated with hypoalbuminaemia which is linked to systemic inflammation. (5) Hydration status is related to plasma albumin concentration but not endothelial dysfunction as measured by soluble biomarkers. Pcl is a function of both local peritoneal factors, e.g. inflammation and progressive fibrosis, and systemic patient characteristics, e.g. age and comorbidity. The influence of comorbidity is complex depending on type, associated patterns of endothelial injury and causes of associated hypoalbuminaemia. The importance of plasma colloidal pressure in determining fluid status was emphasized. Strategies to improve fluid distribution should focus on reducing peritoneal protein loss and increasing albumin synthesis rather than blocking systemic vascular leak.

Published
2013

12. Supplemental Material, sj-pdf-2-ptd-10.1177_0896860820982218 - ISPD recommendations for the evaluation of peritoneal membrane dysfunction in adults: Classification, measurement, interpretation and rationale for intervention

Author

Morelle, Johann, Stachowska-Pietka, Joanna, Öberg, Carl, Gadola, Liliana, La Milia, Vincenzo, Yu, Zanzhe, Lambie, Mark, Mehrotra, Rajnish, de Arteaga, Javier, and Davies, Simon

Subjects
Medicine
Abstract

Supplemental Material, sj-pdf-2-ptd-10.1177_0896860820982218 for ISPD recommendations for the evaluation of peritoneal membrane dysfunction in adults: Classification, measurement, interpretation and rationale for intervention by Johann Morelle, Joanna Stachowska-Pietka, Carl Öberg, Liliana Gadola, Vincenzo La Milia, Zanzhe Yu, Mark Lambie, Rajnish Mehrotra, Javier de Arteaga and Simon Davies in Peritoneal Dialysis International

Published
2023
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13. Supplemental Material, sj-pdf-1-ptd-10.1177_0896860820982218 - ISPD recommendations for the evaluation of peritoneal membrane dysfunction in adults: Classification, measurement, interpretation and rationale for intervention

Author

Morelle, Johann, Stachowska-Pietka, Joanna, Öberg, Carl, Gadola, Liliana, La Milia, Vincenzo, Yu, Zanzhe, Lambie, Mark, Mehrotra, Rajnish, de Arteaga, Javier, and Davies, Simon

Subjects
Medicine
Abstract

Supplemental Material, sj-pdf-1-ptd-10.1177_0896860820982218 for ISPD recommendations for the evaluation of peritoneal membrane dysfunction in adults: Classification, measurement, interpretation and rationale for intervention by Johann Morelle, Joanna Stachowska-Pietka, Carl Öberg, Liliana Gadola, Vincenzo La Milia, Zanzhe Yu, Mark Lambie, Rajnish Mehrotra, Javier de Arteaga and Simon Davies in Peritoneal Dialysis International

Published
2023
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14. Supplemental Material, sj-pdf-3-ptd-10.1177_0896860820982218 - ISPD recommendations for the evaluation of peritoneal membrane dysfunction in adults: Classification, measurement, interpretation and rationale for intervention

Author

Morelle, Johann, Stachowska-Pietka, Joanna, Öberg, Carl, Gadola, Liliana, La Milia, Vincenzo, Yu, Zanzhe, Lambie, Mark, Mehrotra, Rajnish, de Arteaga, Javier, and Davies, Simon

Subjects
Medicine
Abstract

Supplemental Material, sj-pdf-3-ptd-10.1177_0896860820982218 for ISPD recommendations for the evaluation of peritoneal membrane dysfunction in adults: Classification, measurement, interpretation and rationale for intervention by Johann Morelle, Joanna Stachowska-Pietka, Carl Öberg, Liliana Gadola, Vincenzo La Milia, Zanzhe Yu, Mark Lambie, Rajnish Mehrotra, Javier de Arteaga and Simon Davies in Peritoneal Dialysis International

Published
2023
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15. Automated peritoneal dialysis in urgent‐start dialysis ESRD patients: Safety and dialysis adequacy

Author

Jin, Haijiao, primary, Lv, Shifan, additional, Wang, Ling, additional, Zhang, Minfang, additional, Wang, Qin, additional, Fang, Wei, additional, Lin, Xinghui, additional, Che, Xiajing, additional, Yan, Hao, additional, Yu, Zanzhe, additional, Jiang, Na, additional, Li, Zhenyuan, additional, Che, Miaoling, additional, Ding, Li, additional, Huang, Jiaying, additional, Zhou, Yin, additional, and Ni, Zhaohui, additional

Published
2022
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17. High intraperitoneal interleukin-6 levels predict ultrafiltration (UF) insufficiency in peritoneal dialysis patients: A prospective cohort study

Author

Song, Qianhui, Yang, Xiaoxiao, Shi, Yuanyuan, Yan, Hao, Yu, Zanzhe, Li, Zhenyuan, Yuan, Jiangzi, Ni, Zhaohui, Gu, Leyi, and Fang, Wei

Subjects
General Medicine
Abstract

IntroductionUF insufficiency is a major limitation in PD efficiency and sustainability. Our study object to investigate the efficacy of intraperitoneal inflammation marker, IL-6 level as a predictor of UF insufficiency in continuous ambulatory peritoneal dialysis (CAPD) patients.MethodsStable prevalent CAPD patients were enrolled in this prospective study. IL-6 concentration in the overnight effluent was determined and expressed as the IL-6 appearance rate (IL-6 AR). Patients were divided into two groups according to the median of IL-6 AR and prospectively followed up until death, transfer to permanent HD, recovery of renal function, kidney transplantation, transfer to other centers, lost to follow-up or to the end of study (January 31, 2021). Factors associated with UF capacity as well as dialysate IL-6 AR were assessed by multivariable linear regression. Cox proportional hazards model was used to examine the association between dialysate IL-6 AR and UF insufficiency.ResultsA total of 291 PD patients were enrolled, including 148 males (51%) with a mean age of 56.6 ± 14.1 years and a median PD duration of 33.4 (12.7–57.5) months. No correlation was found between dialysate IL-6 AR and UF capacity at baseline. PD duration was found positively correlated with baseline dialysate IL-6 AR, while 24h urine volume was negatively correlated with baseline dialysate IL-6 AR (P < 0.05). By the end of study, UF insufficiency was observed in 56 (19.2%) patients. Patients in the high IL-6 AR group showed a significantly inferior UF insufficiency-free survival when compared with their counterparts in the low IL-6 AR group (P = 0.001). In the multivariate Cox regression analysis, after adjusting for DM, previous peritonitis episode and 24h urine volume, higher baseline dialysate IL-6 AR (HR 3.639, 95% CI 1.776–7.456, P = 0.002) were associated with an increased risk of UF insufficiency. The area under the ROC curve (AUC) for baseline IL-6 AR to predict UF insufficiency was 0.663 (95% CI, 0.580–0.746; P < 0.001).ConclusionOur study suggested that the dialysate IL-6 AR could be a potential predictor of UF insufficiency in patients undergoing PD.

Published
2022
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19. Automated peritoneal dialysis in urgent‐start dialysis ESRD patients: Safety and dialysis adequacy.

Author

Jin, Haijiao, Lv, Shifan, Wang, Ling, Zhang, Minfang, Wang, Qin, Fang, Wei, Lin, Xinghui, Che, Xiajing, Yan, Hao, Yu, Zanzhe, Jiang, Na, Li, Zhenyuan, Che, Miaoling, Ding, Li, Huang, Jiaying, Zhou, Yin, and Ni, Zhaohui

Subjects
PERITONEAL dialysis, HEMODIALYSIS patients, CHRONIC kidney failure, PATIENT safety, OVERALL survival
Abstract

Background: Recent evidence suggests that automated peritoneal dialysis (APD) might be a feasible alternative to hemodialysis (HD) in urgent‐start peritoneal dialysis. Methods: This prospective study enrolled end‐stage renal disease (ESRD) patients who had started APD as an urgent‐start dialysis modality at a single center. Dialysis‐related complications were recorded. Dialysis adequacy and electrolytes imbalance were compared between baseline, 14 and 42 days after catheter insertion. Technique survival and patient survival were also recorded. Results: A total of 36 patients were included in the study. Mean follow‐up duration was 22 months. During the follow‐up, 11 PD patients (30.6%) developed dialysis‐related complications. Only two patients (5.6%) required re‐insertion and one patients (2.8%) transfer to HD. The 2‐year technique survival rate and patient survival rate were 94.4% and 97.2%, respectively. Conclusion: In considering safety and dialysis adequacy, APD could be a feasible dialysis modality for urgent‐start dialysis in ESRD patients, using a standard procedure. [ABSTRACT FROM AUTHOR]

Published
2023
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24. AQP1 Promoter Variant, Water Transport, and Outcomes in Peritoneal Dialysis

Author

Morelle, Johann, primary, Marechal, Céline, additional, Yu, Zanzhe, additional, Debaix, Huguette, additional, Corre, Tanguy, additional, Lambie, Mark, additional, Verduijn, Marion, additional, Dekker, Friedo, additional, Bovy, Philippe, additional, Evenepoel, Pieter, additional, Bammens, Bert, additional, Selgas, Rafael, additional, Bajo, Maria A., additional, Coester, Annemieke M., additional, Sow, Amadou, additional, Hautem, Nicolas, additional, Struijk, Dirk G., additional, Krediet, Raymond T., additional, Balligand, Jean-Luc, additional, Goffin, Eric, additional, Crott, Ralph, additional, Ripoche, Pierre, additional, Davies, Simon, additional, and Devuyst, Olivier, additional

Published
2021
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25. Supplemental Material, sj-docx-1-ptd-10.1177_0896860820982218 - ISPD recommendations for the evaluation of peritoneal membrane dysfunction in adults: Classification, measurement, interpretation and rationale for intervention

Author

Morelle, Johann, Stachowska-Pietka, Joanna, Öberg, Carl, Gadola, Liliana, La Milia, Vincenzo, Yu, Zanzhe, Lambie, Mark, Mehrotra, Rajnish, de Arteaga, Javier, and Davies, Simon

Subjects
Medicine
Abstract

Supplemental Material, sj-docx-1-ptd-10.1177_0896860820982218 for ISPD recommendations for the evaluation of peritoneal membrane dysfunction in adults: Classification, measurement, interpretation and rationale for intervention by Johann Morelle, Joanna Stachowska-Pietka, Carl Öberg, Liliana Gadola, Vincenzo La Milia, Zanzhe Yu, Mark Lambie, Rajnish Mehrotra, Javier de Arteaga and Simon Davies in Peritoneal Dialysis International

Published
2021
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28. ISPD recommendations for the evaluation of peritoneal membrane dysfunction in adults: Classification, measurement, interpretation and rationale for intervention.

Author

UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Morelle, Johann, Stachowska-Pietka, Joanna, Öberg, Carl, Gadola, Liliana, La Milia, Vincenzo, Yu, Zanzhe, Lambie, Mark, Mehrotra, Rajnish, de Arteaga, Javier, Davies, Simon, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Morelle, Johann, Stachowska-Pietka, Joanna, Öberg, Carl, Gadola, Liliana, La Milia, Vincenzo, Yu, Zanzhe, Lambie, Mark, Mehrotra, Rajnish, de Arteaga, Javier, and Davies, Simon

Abstract

A pathophysiological classification of membrane dysfunction, which provides mechanistic links to functional characteristics, should be used when prescribing individualized dialysis or when planning modality transfer (e.g. to automated peritoneal dialysis (PD) or haemodialysis) in the context of shared and informed decision-making with the person on PD, taking individual circumstances and treatment goals into account. (). It is recommended that the PSTR is determined from a 4-h peritoneal equilibration test (PET), using either 2.5%/2.27% or 4.25%/3.86% dextrose/glucose concentration and creatinine as the index solute. () This should be done early in the course dialysis treatment (between 6 weeks and 12 weeks) () and subsequently when clinically indicated. (). A faster PSTR is associated with lower survival on PD. () This risk is in part due to the lower ultrafiltration (UF) and increased net fluid reabsorption that occurs when the PSTR is above the average value. The resulting lower net UF can be avoided by shortening glucose-based exchanges, using a polyglucose solution (icodextrin), and/or prescribing higher glucose concentrations. () Compared to glucose, use of icodextrin can translate into improved fluid status and fewer episodes of fluid overload. () Use of automated PD and icodextrin may mitigate the mortality risk associated with fast PSTR. (). UF This is easy to measure and a valuable screening test. Insufficient UF should be suspected when either (a) the net UF from a 4-h PET is <400 ml (3.86% glucose/4.25% dextrose) or <100 ml (2.27% glucose /2.5% dextrose), () and/or (b) the daily UF is insufficient to maintain adequate fluid status. () Besides membrane dysfunction, low UF capacity can also result from mechanical problems, leaks or increased fluid absorption across the peritoneal membrane not explained by fast PSTR. Diagnosing intrinsic membrane dysfunction (manifesting as low osmotic conductance to glucose) as a cause of UF insufficiency: When insufficien

Published
2021

29. AQP1 Promoter Variant, Water Transport, and Outcomes in Peritoneal Dialysis

Author

UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - SSS/IREC/FATH - Pôle de Pharmacologie et thérapeutique, UCL - SSS/IRSS - Institut de recherche santé et société, UCL - (SLuc) Service de médecine interne et maladies infectieuses (MIMI), UCL - (SLuc) Service de néphrologie, Morelle, Johann, Marechal, Céline, Yu, Zanzhe, Debaix, Huguette, Corre, Tanguy, Lambie, Mark, Verduijn, Marion, Dekker, Friedo, Bovy, Philippe, Evenepoel, Pieter, Bammens, Bert, Selgas, Rafael, Bajo, Maria A., Coester, Annemieke M., Sow-Diallo, Amadou, Hautem, Nicolas, Struijk, Dirk G., Krediet, Raymond T., Balligand, Jean-Luc, Goffin, Eric, Crott, Ralph, Ripoche, Pierre, Davies, Simon, Devuyst, Olivier, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - SSS/IREC/FATH - Pôle de Pharmacologie et thérapeutique, UCL - SSS/IRSS - Institut de recherche santé et société, UCL - (SLuc) Service de médecine interne et maladies infectieuses (MIMI), UCL - (SLuc) Service de néphrologie, Morelle, Johann, Marechal, Céline, Yu, Zanzhe, Debaix, Huguette, Corre, Tanguy, Lambie, Mark, Verduijn, Marion, Dekker, Friedo, Bovy, Philippe, Evenepoel, Pieter, Bammens, Bert, Selgas, Rafael, Bajo, Maria A., Coester, Annemieke M., Sow-Diallo, Amadou, Hautem, Nicolas, Struijk, Dirk G., Krediet, Raymond T., Balligand, Jean-Luc, Goffin, Eric, Crott, Ralph, Ripoche, Pierre, Davies, Simon, and Devuyst, Olivier

Abstract

BACKGROUND: Variability in ultrafiltration influences prescriptions and outcomes in patients with kidney failure who are treated with peritoneal dialysis. Variants in AQP1, the gene that encodes the archetypal water channel aquaporin-1, may contribute to that variability. METHODS: We gathered clinical and genetic data from 1851 patients treated with peritoneal dialysis in seven cohorts to determine whether AQP1 variants were associated with peritoneal ultrafiltration and with a risk of the composite of death or technique failure (i.e., transfer to hemodialysis). We performed studies in cells, mouse models, and samples obtained from humans to characterize an AQP1 variant and investigate mitigation strategies. RESULTS: The common AQP1 promoter variant rs2075574 was associated with peritoneal ultrafiltration. Carriers of the TT genotype at rs2075574 (10 to 16% of patients) had a lower mean (±SD) net ultrafiltration level than carriers of the CC genotype (35 to 47% of patients), both in the discovery phase (506±237 ml vs. 626±283 ml, P = 0.007) and in the validation phase (368±603 ml vs. 563±641 ml, P = 0.003). After a mean follow-up of 944 days, 139 of 898 patients (15%) had died and 280 (31%) had been transferred to hemodialysis. TT carriers had a higher risk of the composite of death or technique failure than CC carriers (adjusted hazard ratio, 1.70; 95% confidence interval [CI], 1.24 to 2.33; P = 0.001), as well as a higher risk of death from any cause (24% vs. 15%, P = 0.03). In mechanistic studies, the rs2075574 risk variant was associated with decreases in AQP1 promoter activity, aquaporin-1 expression, and glucose-driven osmotic water transport. The use of a colloid osmotic agent mitigated the effects of the risk variant. CONCLUSIONS: A common variant in AQP1 was associated with decreased ultrafiltration and an increased risk of death or technique failure among patients treated with peritoneal dialysis. (Funded by the Swiss National Science Foundation and others

Published
2021

30. AQP1 Promoter Variant, Water Transport, and Outcomes in Peritoneal Dialysis

Author

Morelle, Johann; https://orcid.org/0000-0002-6925-1989, Marechal, Céline, Yu, Zanzhe, Debaix, Huguette, Corre, Tanguy, Lambie, Mark; https://orcid.org/0000-0002-6285-5368, Verduijn, Marion, Dekker, Friedo, Bovy, Philippe, Evenepoel, Pieter, Bammens, Bert, Selgas, Rafael, Bajo, Maria A, Coester, Annemieke M, Sow, Amadou, Hautem, Nicolas, Struijk, Dirk G, Krediet, Raymond T, Balligand, Jean-Luc, Goffin, Eric, Crott, Ralph, Ripoche, Pierre, Davies, Simon, Devuyst, Olivier; https://orcid.org/0000-0003-3744-4767, Morelle, Johann; https://orcid.org/0000-0002-6925-1989, Marechal, Céline, Yu, Zanzhe, Debaix, Huguette, Corre, Tanguy, Lambie, Mark; https://orcid.org/0000-0002-6285-5368, Verduijn, Marion, Dekker, Friedo, Bovy, Philippe, Evenepoel, Pieter, Bammens, Bert, Selgas, Rafael, Bajo, Maria A, Coester, Annemieke M, Sow, Amadou, Hautem, Nicolas, Struijk, Dirk G, Krediet, Raymond T, Balligand, Jean-Luc, Goffin, Eric, Crott, Ralph, Ripoche, Pierre, Davies, Simon, and Devuyst, Olivier; https://orcid.org/0000-0003-3744-4767

Abstract

Background: Variability in ultrafiltration influences prescriptions and outcomes in patients with kidney failure who are treated with peritoneal dialysis. Variants in AQP1, the gene that encodes the archetypal water channel aquaporin-1, may contribute to that variability. Methods: We gathered clinical and genetic data from 1851 patients treated with peritoneal dialysis in seven cohorts to determine whether AQP1 variants were associated with peritoneal ultrafiltration and with a risk of the composite of death or technique failure (i.e., transfer to hemodialysis). We performed studies in cells, mouse models, and samples obtained from humans to characterize an AQP1 variant and investigate mitigation strategies. Results: The common AQP1 promoter variant rs2075574 was associated with peritoneal ultrafiltration. Carriers of the TT genotype at rs2075574 (10 to 16% of patients) had a lower mean (±SD) net ultrafiltration level than carriers of the CC genotype (35 to 47% of patients), both in the discovery phase (506±237 ml vs. 626±283 ml, P = 0.007) and in the validation phase (368±603 ml vs. 563±641 ml, P = 0.003). After a mean follow-up of 944 days, 139 of 898 patients (15%) had died and 280 (31%) had been transferred to hemodialysis. TT carriers had a higher risk of the composite of death or technique failure than CC carriers (adjusted hazard ratio, 1.70; 95% confidence interval [CI], 1.24 to 2.33; P = 0.001), as well as a higher risk of death from any cause (24% vs. 15%, P = 0.03). In mechanistic studies, the rs2075574 risk variant was associated with decreases in AQP1 promoter activity, aquaporin-1 expression, and glucose-driven osmotic water transport. The use of a colloid osmotic agent mitigated the effects of the risk variant. Conclusions: A common variant in AQP1 was associated with decreased ultrafiltration and an increased risk of death or technique failure among patients treated with peritoneal dialysis. (Funded by the Swiss National Science Foundation and others

Published
2021

31. ISPD recommendations for the evaluation of peritoneal membrane dysfunction in adults: Classification, measurement, interpretation and rationale for intervention

Author

Morelle, Johann, primary, Stachowska-Pietka, Joanna, additional, Öberg, Carl, additional, Gadola, Liliana, additional, La Milia, Vincenzo, additional, Yu, Zanzhe, additional, Lambie, Mark, additional, Mehrotra, Rajnish, additional, de Arteaga, Javier, additional, and Davies, Simon, additional

Published
2021
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34. Leflunomide plus low-dose prednisone in patients with progressive IgA nephropathy: a multicenter, prospective, randomized, open-labeled, and controlled trial

Author

Ni, Zhaohui, primary, Zhang, Zhen, additional, Yu, Zanzhe, additional, Lu, Fuming, additional, Mei, Changlin, additional, Ding, Xiaoqiang, additional, Yuan, Weijie, additional, Zhang, Wei, additional, Jiang, Gengru, additional, Sun, Min, additional, He, Liqun, additional, Deng, Yueyi, additional, Pang, Huihua, additional, and Qian, Jiaqi, additional

Published
2021
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36. Leflunomide Plus Low-dose Prednisone in Patients with Progressive IgA Nephropathy: A Multicenter, Prospective, Randomized, Open-labelled and Controlled Trial

Author

Ni, Zhaohui, primary, Zhang, Zhen, additional, Yu, Zanzhe, additional, Lu, Fuming, additional, Mei, Changlin, additional, Ding, Xiaoqiang, additional, Yuan, Weijie, additional, Zhang, Wei, additional, Jiang, Gengru, additional, Sun, Min, additional, He, Liqun, additional, Deng, Yueyi, additional, and Pang, Huihua, additional

Published
2020
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42. Peritoneal Dialysis as an Option for Unplanned Dialysis Initiation in Patients with End-Stage Renal Disease and Diabetes Mellitus

Author

Jin, Haijiao, primary, Ni, Zhaohui, additional, Che, Xiajing, additional, Gu, Leyi, additional, Zhu, Mingli, additional, Yuan, Jiangzi, additional, Huang, Jiaying, additional, Gu, Aiping, additional, Jin, Yan, additional, Yan, Hao, additional, Wang, Qin, additional, Yu, Zanzhe, additional, Zhou, Wenyan, additional, and Fang, Wei, additional

Published
2018
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44. SP512FEASIBILITY OF PERITONEAL DIALYSIS IN ESRD PATIENTS

Author

Jin, Haijiao, primary, Fang, Wei, additional, Zhu, Mingli, additional, Yan, Hao, additional, Fang, Yan, additional, Yu, Zanzhe, additional, Zhang, Minfang, additional, Wang, Qin, additional, Che, Xiajing, additional, Zhang, Haifen, additional, Huang, Jiaying, additional, Hu, Chunhua, additional, Xie, Yuanyuan, additional, Mou, Shan, additional, and Ni, Zhaohui, additional

Published
2017
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45. Comparison of combined leflunomide and low-dose corticosteroid therapy with full-dose corticosteroid monotherapy for progressive IgA nephropathy

Author

Min, Lulin, primary, Wang, Qin, additional, Cao, Liou, additional, Zhou, Wenyan, additional, Yuan, Jiangzi, additional, Zhang, Minfang, additional, Che, Xiajing, additional, Mou, Shan, additional, Fang, Wei, additional, Gu, Leyi, additional, Zhu, Mingli, additional, Wang, Ling, additional, Yu, Zanzhe, additional, Qian, Jiaqi, additional, and Ni, Zhaohui, additional

Published
2017
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47. IL-6 trans-signaling drives a STAT3-dependent pathway that leads to structural alterations of the peritoneal membrane

Author

Yang, Xiaoxiao, Yan, Hao, Jiang, Na, Yu, Zanzhe, Yuan, Jiangzi, Ni, Zhaohui, and Fang, Wei

Abstract

IL-6 is a vital inflammatory factor in the peritoneal cavity of patients undergoing peritoneal dialysis (PD). The present study examined the effect of IL-6 trans-signaling on structural alterations of the peritoneal membrane. We investigated whether the epithelial-to-mesenchymal transition (EMT) process of human peritoneal mesothelial cells (HPMCs) and the production of proangiogenic factors were controlled by IL-6 trans-signaling. Its role in the peritoneal alterations was detected in a mouse model. The morphology of HPMCs and levels of cytokines in PD effluent were also explored. Stimulation of HPMCs with the IL-6 and soluble IL-6 receptor complex (IL-6/S) promoted the EMT process of HPMCs depending on the STAT3 pathway. In a coculture system of HPMCs and human umbilical vein endothelial cells, IL-6/S mediated the production of VEGF and angiopoietins so as to downregulate the expression of endothelial junction molecules and finally affect vascular permeability. Daily intraperitoneal injection of high glucose-based dialysis fluid induced peritoneal fibrosis, angiogenesis, and macrophage infiltration in a mouse model, accompanied by phosphorylation of STAT3. Blockade of IL-6 trans-signaling prevented these peritoneum alterations. The fibroblast-like appearance of HPMCs ex vivo was upregulated in patients undergoing prevalent PD accompanied by increasing levels of IL-6, VEGF, and angiopoietin-2 in the PD effluent. Taken together, these findings identified a critical link between IL-6 trans-signaling and structural alterations of the peritoneal membrane, and it might be a potential target for the treatment of patients undergoing PD who have developed peritoneal alterations.

Published
2020
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48. Urgent-Start Peritoneal Dialysis and Hemodialysis in ESRD Patients: Complications and Outcomes

Author

Jin, Haijiao, primary, Fang, Wei, additional, Zhu, Mingli, additional, Yu, Zanzhe, additional, Fang, Yan, additional, Yan, Hao, additional, Zhang, Minfang, additional, Wang, Qin, additional, Che, Xiajing, additional, Xie, Yuanyuan, additional, Huang, Jiaying, additional, Hu, Chunhua, additional, Zhang, Haifen, additional, Mou, Shan, additional, and Ni, Zhaohui, additional

Published
2016
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50. The Incidence Prognosis and Risk Factors of Cognitive Impairment in Maintenance Haemodialysis Patients.

Author

Lu, Renhua, Xu, Chenqi, Li, Yan, Yu, Ling, Shao, Xinghua, Xie, Kewei, Gu, Jiaqi, Yu, Zanzhe, Yan, Yucheng, Guan, Yangtai, Ni, Zhaohui, Ronco, Claudio, and Gu, Leyi

Subjects
UNILATERAL neglect, DISEASE risk factors
Abstract

Objective: To investigate the incidence and the prognosis of cognitive impairment (CI) and to find out the risk factors associated with the outcome in maintenance haemodialysis (MHD) patients. Methods: Enrolled the patients who met the criteria as below: MHD (≥3 months) patients before July 2014, ≥18 years old and could carry on the cognitive function test (Montreal Cognitive Assessment [MoCA]). All enrolled patients were divided into 2 groups: CI group (MoCA < 26) and non-CI group (MoCA ≥26). All patients were followed up for 36 months. The incidence, demography data, medical history, haemodialysis data, laboratory examination and prognosis of CI in haemodialysis patients were prospectively compared and analyzed. Multivariate logistic regression analysis was used to investigate the risk factors of CI. Kaplan-Meier survival curve was used for survival analysis. Results: In the present study, 219 patients were enrolled. The ratio of male to female was 1.46: 1. Age was 60.07 ± 12.44 and dialysis vintage was 100.79 ± 70.23 months. One hundred thirteen patients' MoCA scores were lower than 26 were divided into CI group. Education status (OR 3.428), post-dialysis diastolic pressure (OR 2.234) and spKt/V (OR 1.982) were independent risk factors for CI in MHD patients. During the follow-up period, 15 patients died (13.2%) in the CI group and 5 died (4.72%) in the non-CI group (p < 0.05). The Kaplan-Meier survival curve analysis showed that the survival rate of patients with CI was lower than that of non-CI group in MHD patients during 3 years follow-up (p = 0.046). Conclusion: CI is one of the most common complications in MHD patients. The mortality is high in patients who had CI. Education status, post-dialysis diastolic pressure and spKt/V are independent risk factors for CI in MHD patients. [ABSTRACT FROM AUTHOR]

Published
2019
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