背景:腹膜纤维化(PF)是主要的,长期腹膜透析的持续并发症,最终导致腹膜超滤失败和腹膜透析终止。长时间接触高浓度的葡萄糖,降解产物,尿毒症毒素,腹膜炎的发作会导致腹膜的一些变化,导致腹膜内炎症和PF,导致超滤和透析失败。CA-125可用作腹膜透析液中腹膜间苯二甲酸细胞计数的生物标志物,并用于监测PD患者的细胞计数。据报道,缺氧诱导因子1-α(HIF-1α)可导致PF,但尚未报道与腹膜结构的变化有关。我们假设可以使用HIF-1α和CA-125值跟踪腹膜充分性。在本研究中,因此,我们研究了HIF-1α和CA-125水平与PD患者顶膜通透性变化之间的关系。
方法:45例患者纳入研究。其中20例的腹膜通透性是恒定的,而腹膜通透性增加11例,下降14例。测量来自患者血液样品的HIF-1α值和来自腹膜液的CA-125测量值。随访后研究腹膜变异性与CA-125和HIF水平之间的关系。
结果:我们比较了接受腹膜透析治疗的三组患者的血清HIF-1α和腹膜液CA-125水平。HIF-1α水平随腹膜通透性改变而升高,而CA-125水平下降。在高至低渗透性变化的患者中,与稳定或低至高变化的HIF-1α水平相比,HIF-1α水平较高,具有统计学意义。相反,在腹膜通透性从高到低的患者中,CA-125水平显着降低,与其他两组相比。
结论:腹膜结构的变化可以通过生物标志物来追踪。已经表明CA-125和HIF-1α水平可以指导腹膜的变化。这可用于腹膜透析的监测。
BACKGROUND: Peritoneal fibrosis (PF) is a major, persistent complication of prolonged peritoneal dialysis that eventually leads to peritoneal ultrafiltration failure and termination of peritoneal dialysis. Prolonged exposure to high glucose concentrations, degradation products, uremic toxins, and episodes of peritonitis can cause some changes in the peritoneal membrane, resulting in intraperitoneal inflammation and PF, leading to failure of ultrafiltration and dialysis. CA-125 can be used as a biomarker of peritoneal mesothelial cell count in the peritoneal dialysate and for monitoring cell count in PD patients. Hypoxia-inducible factor 1-alpha (HIF-1α) has been reported to cause PF, but has not been reported to be associated with changes in peritoneal structure. We hypothesized that peritoneal adequacy can be followed using HIF-1α and CA-125 values. In the present study, therefore, we investigated the relationship between HIF-1α and CA-125 levels and parietal membrane permeability changes in PD patients.
METHODS: Forty-five patients were included in the study. Peritoneal permeability was constant in 20 of these, while peritoneal permeability increased in 11 and decreased in 14. The HIF-1α value from the blood samples of the patients and the CA-125 measurement from the peritoneal fluids were measured. The relationship between peritoneal variability and CA-125 and HIF levels after follow-up was investigated.
RESULTS: We compared serum HIF-1α and peritoneal fluid CA-125 levels in the three groups receiving peritoneal dialysis treatment. HIF-1α levels increased with peritoneal permeability changes, while CA-125 levels decreased. In patients with high to low permeability changes, HIF-1α levels were higher compared to those with stable or low to high changes, which was statistically significant. Conversely, CA-125 levels significantly decreased in patients whose peritoneal permeability changed from high to low, compared to the other two groups.
CONCLUSIONS: Changes in peritoneal structure can be followed with biomarkers. It has been shown that CA-125 and HIF-1α levels can guide the changes in the peritoneal membrane. This can be useful in the monitoring of peritoneal dialysis.